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Reduction of urgency severity is associated with long‐term therapeutic effect after intravesical onabotulinumtoxina injection for idiopathic detrusor overactivity
Author(s) -
Kuo HannChorng
Publication year - 2011
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.21132
Subject(s) - medicine , refractory (planetary science) , therapeutic effect , sensory system , overactive bladder , retrospective cohort study , young adult , anesthesia , psychology , physics , alternative medicine , pathology , astrobiology , cognitive psychology
Aims Intravesical onabotulinumtoxinA (BoNT‐A) injection is a promising treatment for refractory detrusor overactivity (DO). This study investigated the long‐term success rate of BoNT‐A injection for patients with idiopathic DO and its association with reduction of urgency severity. Methods This study was a retrospective analysis of 174 patients with idiopathic DO who received first‐time 100 U BoNT‐A injections. The patients were collected from several previous clinical trials. The therapeutic effects were classified as significant sensory effects with urgency severity score reductions of ≥2 and/or significant motor effects with cystometric bladder capacity increases of ≥25%. The treatment results based on patients' perceptions of bladder conditions and long‐term success rates were analyzed among the different therapeutic‐effect subgroups. Results A successful outcome was reported by 138 (79.3%) patients at 3 months. Seventy‐seven (44.3%) patients had both sensory and motor effects, 5 (2.9%) had sensory effects alone, 83 (47.7%) had motor effects alone, and 9 (5.2%) had no sensory or motor effect. All 82 patients with sensory with/without motor effects reported a successful result. In contrast, only 50 (60.2%) patients with motor effects alone reported success at 3 months. Increased cystometric bladder capacity and postvoid residual and decreased voiding efficiency were noted in patients with motor with/without sensory effects. The therapeutic results lasted significantly longer in patients with sensory with/without motor effects than those with motor effects alone. Conclusions Improvement of urgency severity is significantly associated with a higher success rate at 3 months and longer therapeutic duration after intravesical BoNT‐A injection for IDO. Neurourol. Urodynam. Neurourol. Urodynam. 30: 1497–1502, 2011. © 2011 Wiley Periodicals, Inc.