PURPOSE: In this 6-month followup study we investigated the effect of intradetrusor injection of 100 U botulinum toxin type A in patients with Parkinson's disease and refractory detrusor overactivity. MATERIALS AND METHODS: Eight patients with Parkinson's disease and detrusor overactivity refractory to anticholinergics were injected with 100 U botulinum toxin type A. Daytime and nighttime urinary frequency, and urinary incontinence episodes were recorded. Patients also completed a standardized quality of life questionnaire on incontinence and a visual analog scale on the impact of bladder problems on daily life activities, and underwent urodynamic assessment, including pressure flow studies. Clinical and urodynamic assessment was performed before, and 1, 3 and 6 months after injection. RESULTS: In all patients 100 U botulinum toxin type A induced decreased daytime and nighttime urinary frequency, a decreased number of urinary incontinence episodes, increased quality of life scores and, as shown by increased maximum cystometric capacity, improved urodynamic findings. In 2 patients with Parkinson's disease post-void residual urine volume developed. CONCLUSIONS: Intradetrusor injection of 100 U botulinum toxin type A induced clinical and urodynamic improvement in overactive bladder symptoms that lasted at least 6 months in patients with Parkinson's disease.
PURPOSE: In this 6-month followup study we investigated the effect of intradetrusor injection of 100 U botulinum toxin type A in patients with Parkinson's disease and refractory detrusor overactivity. MATERIALS AND METHODS: Eight patients with Parkinson's disease and detrusor overactivity refractory to anticholinergics were injected with 100 U botulinum toxin type A. Daytime and nighttime urinary frequency, and urinary incontinence episodes were recorded. Patients also completed a standardized quality of life questionnaire on incontinence and a visual analog scale on the impact of bladder problems on daily life activities, and underwent urodynamic assessment, including pressure flow studies. Clinical and urodynamic assessment was performed before, and 1, 3 and 6 months after injection. RESULTS: In all patients 100 U botulinum toxin type A induced decreased daytime and nighttime urinary frequency, a decreased number of urinary incontinence episodes, increased quality of life scores and, as shown by increased maximum cystometric capacity, improved urodynamic findings. In 2 patients with Parkinson's disease post-void residual urine volume developed. CONCLUSIONS: Intradetrusor injection of 100 U botulinum toxin type A induced clinical and urodynamic improvement in overactive bladder symptoms that lasted at least 6 months in patients with Parkinson's disease.
Authors: Doreen McClurg; Jalesh Panicker; Richard W Walker; AnneLouise Cunnington; Katherine H O Deane; Danielle Harari; Andrew Elders; Jo Booth; Suzanne Hagen; Helen Mason; Susan Stratton Journal: BMJ Open Date: 2020-02-17 Impact factor: 2.692