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Intradetrusor injection of botulinum‐A toxin in patients with idiopathic and neurogenic detrusor overactivity: Urodynamic outcome and patient satisfaction
Author(s) -
Ghalayini Ibrahim Fathi,
AlGhazo Mohammed A.
Publication year - 2007
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20403
Subject(s) - medicine , botulinum toxin , patient satisfaction , urodynamic studies , urology , anesthesia , surgery , urinary incontinence
Purpose To assess and compare the efficacy of botulinum‐A toxin (BTX‐A) injections into the detrusor in idiopathic and neurogenic detrusor overactivity (IDO and NDO) resistant to anticholinergic treatment with respect to patient satisfaction. Patients and Methods In a prospective study, 16 patients with IDO and 14 with NDO resistant to anticholinergic treatment were injected with 500 U of Dysport® into the detrusor. Clinical, urodynamic, and satisfaction assessments were performed at baseline and after BTX‐A injections. Results In IDO as well as in NDO, there was a significant increase in median maximum cystometric capacity (MCC) from 177.5 to 262.5 ml ( P < 0.0005) and 160 to 270 ml ( P = 0.001), median bladder compliance from 24.5 to 40.0 ml/cmH 2 O ( P < 0.0005) and 25.5 to 44.0 ml/cmH 2 O ( P = 0.001) and median PVR from 15 to 80 ml ( P = 0.001) and 15.0 to 62.5 ml ( P = 0.001), respectively. Median P det max decreased significantly from 49 to 37 cmH 2 O ( P < 0.0005) and 48.5 to 37.0 cmH 2 O ( P = 0.001), and median P det Q max from 32.0 to 20.0 ml/sec ( P < 0.0005) and 36.0 to 21.5 ml/sec ( P = 0.001), respectively. The effect of BTX‐A injections lasted for a median time of 5 months in both groups. Median daytime frequency, nocturia, and number of used pads decreased significantly in both groups. More than 80% of the patients were satisfied with the effect of BTX‐A. Conclusions Patients with intractable IDO respond to intradetrusor BTX‐A with a significant and comparable but temporally limited effect in urodynamic and LUTS parameters as those with NDO. The majority of patients were satisfied with treatment. Neurourol. Urodynam. 26:531–536, 2007. © 2007 Wiley‐Liss, Inc.