Premium
Botulinum toxin A submucosal injection for refractory non‐neurogenic overactive bladder: Early outcomes
Author(s) -
Okamura Kikuo,
Nojiri Yoshikatsu,
Ameda Kaname,
Namima Takashige,
Suzuki Masahito,
Inoue Katsumi,
Ogawa Takatoshi,
Gotoh Momokazu,
Homma Yukio
Publication year - 2011
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2011.02768.x
Subject(s) - medicine , anticholinergic , overactive bladder , refractory (planetary science) , urology , botulinum toxin , urinary incontinence , adverse effect , saline , urination , constipation , urinary system , urinary urgency , prospective cohort study , anesthesia , physics , alternative medicine , pathology , astrobiology
The objective of the present study was to assess the short‐term effects of botulinum toxin A (BTX‐A) injection for refractory non‐neurogenic overactive bladder (OAB) in the setting of a prospective multicenter clinical trial. Refractory OAB was defined as persistent urgency urinary incontinence (UUI) ≥once a week despite taking anticholinergic agents, or the incapability to continue the agents because of the adverse effects. A total of 100 U of BTX‐A were reconstituted in 15 mL of normal saline and an aliquot of 0.5 mL was injected at 30 submucosal sites of the bladder wall. Nine men and eight women aged 67 ± 12 years were included. Subjective daytime frequency, urgency and UUI significantly decreased after treatment. On a 3‐day frequency‐volume chart, the daytime and night‐time frequency of UUI significantly decreased from 5.5 and 0.5 pre‐injection to 2.0 and 0.3 postinjection, respectively. Daytime urinary incontinence completely disappeared in six subjects. A urodynamic study showed the disappearance of detrusor overactivity in eight patients and a decrease in five patients. Maximum bladder capacity significantly increased from 179.9 to 267.3 mL. Difficulty on micturition or feeling of incomplete emptying was reported by 23.5% and 43.8% of patients at weeks 2 and 4, respectively. Postvoid residual urine increased to >100 mL in seven patients and >200 mL in one patient after injection; however, none of the patients required clean intermittent catheterization. These findings suggest promising efficacy of BTX‐A in Japanese OAB patients.