Nicholas A Faure Walker1, Obaid Syed1, Sachin Malde1, Claire Taylor1, Arun Sahai2. 1. Department of Urology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK. 2. Department of Urology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK. Electronic address: arun.sahai@gstt.nhs.uk.
Abstract
OBJECTIVE: To establish the effectiveness and safety profile of Onaboulinum toxin A (BTX-A) in men with idiopathic detrusor overactivity and compare with the outcomes observed in women. Several randomized trials have demonstrated the effectiveness of intradetrusor BTX-A injections in improving symptoms and quality of life in patients with overactive bladder (OAB) symptoms. Most trials however contained relatively few men or excluded men altogether. MATERIALS AND METHODS: Data patient undergoing BTX-A for refractory OAB with idiopathic detrusor overactivity on urodynamics were extracted from our center's prospectively maintained database. Incontinence impact questionnaire-7 and urogenital distress inventory-6 scores were collected at baseline and 4-12 weeks together with data regarding urinary retention requiring clean intermittent self-catheterization (CISC) and urinary tract infection (UTI). Urodynamic studies were assessed where available to see if voiding dysfunction and CISC were predictable. RESULTS: Sixty-five men received 133 BoNT-A treatments in the 15-year period representing 27.8% of those with refractory OAB. Baseline urogenital distress inventory-6 and incontinence impact questionnaire-7 fell by 4.2 (P = .00) and 6.0 (P = .00) points for men and by 6.0 (P = .00) and 11.1 (P = .00) for women, respectively. De novo CISC was required in 46 (42.6%) men and 107 (35.3%) women (P = .10). UTI was reported in 36 (29.0%) men and 86 (27.0%) women (P = .73). The bladder outflow obstruction index and the bladder contractility index did not reliably predict CISC requirement. CONCLUSION: Men with refractory OAB experience significant improvement in quality of life scores following BTX-A, though the benefit appears greater in women. The requirements for CISC and UTI rates were similar between sexes. Crown
OBJECTIVE: To establish the effectiveness and safety profile of Onaboulinum toxin A (BTX-A) in men with idiopathic detrusor overactivity and compare with the outcomes observed in women. Several randomized trials have demonstrated the effectiveness of intradetrusor BTX-A injections in improving symptoms and quality of life in patients with overactive bladder (OAB) symptoms. Most trials however contained relatively few men or excluded men altogether. MATERIALS AND METHODS: Data patient undergoing BTX-A for refractory OAB with idiopathic detrusor overactivity on urodynamics were extracted from our center's prospectively maintained database. Incontinence impact questionnaire-7 and urogenital distress inventory-6 scores were collected at baseline and 4-12 weeks together with data regarding urinary retention requiring clean intermittent self-catheterization (CISC) and urinary tract infection (UTI). Urodynamic studies were assessed where available to see if voiding dysfunction and CISC were predictable. RESULTS: Sixty-five men received 133 BoNT-A treatments in the 15-year period representing 27.8% of those with refractory OAB. Baseline urogenital distress inventory-6 and incontinence impact questionnaire-7 fell by 4.2 (P = .00) and 6.0 (P = .00) points for men and by 6.0 (P = .00) and 11.1 (P = .00) for women, respectively. De novo CISC was required in 46 (42.6%) men and 107 (35.3%) women (P = .10). UTI was reported in 36 (29.0%) men and 86 (27.0%) women (P = .73). The bladder outflow obstruction index and the bladder contractility index did not reliably predict CISC requirement. CONCLUSION:Men with refractory OAB experience significant improvement in quality of life scores following BTX-A, though the benefit appears greater in women. The requirements for CISC and UTI rates were similar between sexes. Crown
Authors: William Stuart Reynolds; Anne M Suskind; Jennifer T Anger; Benjamin M Brucker; Anne P Cameron; Doreen E Chung; Stephanie Daignault-Newton; Giulia I Lane; Alvaro Lucioni; Arthur P Mourtzinos; Priya Padmanabhan; Polina X Reyblat; Ariana L Smith; Christopher F Tenggardjaja; Una J Lee Journal: Neurourol Urodyn Date: 2022-01-12 Impact factor: 2.367