OBJECTIVES: To define the role of botulinum toxin type A (botulinum-A) intradetrusor injections in the treatment of patients with symptoms of bladder overactivity in whom previous anticholinergic therapy has failed. METHODS: Thirty-five patients (29 women and 6 men) with frequency, urgency, and/or urge incontinence received 300 U of botulinum-A toxin injected transurethrally at 30 sites within the bladder. Patients were evaluated at 3 weeks and 6 months after treatment by completion of the short forms of the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6), as well as questions assessing global response to the treatment. RESULTS: After 3 weeks, the mean IIQ-7 score decreased from 19.4 to 13.9 (P = 0.0006) and the mean UDI-6 score decreased from 16.8 to 12.8 (P = 0.0003). Overall, 21 (60%) of 35 patients reported slight to complete improvement of voiding symptoms after 3 weeks. Among the initial responders followed up for 6 months, the mean IIQ-7 score improved from 20.6 to 15.1 (P = 0.008) and the mean UDI-6 score improved from 16.9 to 13.5 (P = 0.008). Mild hematuria, pelvic pain, and dysuria were seen in 7 patients, lasting for 3 days or less after the procedure. CONCLUSIONS: Botulinum-A toxin injections may provide improvement in symptoms associated with bladder overactivity in a subset of patients. Improvement may be seen for at least 6 months after treatment. The procedure was well tolerated with minimal side effects. Additional study to define the role of injections in a broad group of patients with irritative voiding symptoms is warranted.
OBJECTIVES: To define the role of botulinum toxin type A (botulinum-A) intradetrusor injections in the treatment of patients with symptoms of bladder overactivity in whom previous anticholinergic therapy has failed. METHODS: Thirty-five patients (29 women and 6 men) with frequency, urgency, and/or urge incontinence received 300 U of botulinum-A toxin injected transurethrally at 30 sites within the bladder. Patients were evaluated at 3 weeks and 6 months after treatment by completion of the short forms of the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6), as well as questions assessing global response to the treatment. RESULTS: After 3 weeks, the mean IIQ-7 score decreased from 19.4 to 13.9 (P = 0.0006) and the mean UDI-6 score decreased from 16.8 to 12.8 (P = 0.0003). Overall, 21 (60%) of 35 patients reported slight to complete improvement of voiding symptoms after 3 weeks. Among the initial responders followed up for 6 months, the mean IIQ-7 score improved from 20.6 to 15.1 (P = 0.008) and the mean UDI-6 score improved from 16.9 to 13.5 (P = 0.008). Mild hematuria, pelvic pain, and dysuria were seen in 7 patients, lasting for 3 days or less after the procedure. CONCLUSIONS: Botulinum-A toxin injections may provide improvement in symptoms associated with bladder overactivity in a subset of patients. Improvement may be seen for at least 6 months after treatment. The procedure was well tolerated with minimal side effects. Additional study to define the role of injections in a broad group of patients with irritative voiding symptoms is warranted.
Authors: Bhupendra O Khatri; John F Foley; Jennifer Fink; John F Kramer; Choon Cha; Xiaojun You; John D Warth; Pam Foulds Journal: Int J MS Care Date: 2014
Authors: K-D Sievert; J Bremer; H Burgdörfer; B Domurath; C Hampel; J Kutzenberger; C Seif; M Stöhrer; B Wefer; J Pannek Journal: Urologe A Date: 2007-03 Impact factor: 0.639
Authors: Stefanie Kuschel; Matthias Werner; Daniel Max Schmid; Elke Faust; Bernhard Schuessler Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2008-01-19