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Reduction of urgency severity is the most important factor in the subjective therapeutic outcome of intravesical onabotulinumtoxinA injection for overactive bladder
Author(s) -
Jiang YuanHong,
Kuo HannChorng
Publication year - 2017
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.22925
Subject(s) - overactive bladder , medicine , urology , trigone of urinary bladder , therapeutic effect , urinary urgency , urinary incontinence , urinary bladder , surgery , alternative medicine , pathology
Aims This study investigated the relationship between the subjective outcome assessment and objective parameters after intravesical onabotulinumtoxinA injection in patients with overactive bladder (OAB). Methods A total of 77 consecutive patients with urodynamically confirmed detrusor overactivity were treated with intravesical 100 U of onabotulinumtoxinA in 20 divided injections (5 U in 0.5 ml normal saline each) at different sites sparing the trigone. The primary end‐point was the change in the Global Response Assessment (GRA) 3 months after treatment. All patients were monitored monthly after treatment for up to 6 months. Patients were divided into successful and failed treatment groups according to change in their GRA (≥2 and ≤1, respectively) at 3 months. The changes in voiding diary variables, Urgency Severity Score (USS), Overactive Bladder Symptom Score (OABSS), maximal bladder capacity (MBC), post‐void residual (PVR) volume, and voiding efficiency (VE) were compared between groups at each time point. Results Overall, USS, OABSS, and MBC improved after treatment. Three months after BoNT‐A injection, 49 (64%) patients reported an improvement in the GRA of 2 (n = 30) or 3 (n = 19). Patients with GRA ≥ 2 had significant improvements in OABSS at 3 months, and USS, OABSS, urgency urinary incontinence (UUI), and urgency episodes at 6 months compared with patients with GRA ≤ 1. No significant difference in MBC, PVR, or VE was noted between groups at 3 or 6 months. Conclusions Subjectively successful treatment outcomes of intravesical onabotulinumtoxinA injection for OAB patients were associated with improvement in OAB symptoms but not increased bladder capacity. Neurourol. Urodynam. 36:338–343, 2017 . © 2015 Wiley Periodicals, Inc.