JOURNAL ARTICLE

Intradetrusor injection of botulinum-A toxin in patients with idiopathic and neurogenic detrusor overactivity: urodynamic outcome and patient satisfaction

Ibrahim Fathi Ghalayini, Mohammed A Al-Ghazo
Neurourology and Urodynamics 2007, 26 (4): 531-536
17330289

PURPOSE: To assess and compare the efficacy of botulinum-A toxin (BTX-A) injections into the detrusor in idiopathic and neurogenic detrusor overactivity (IDO and NDO) resistant to anticholinergic treatment with respect to patient satisfaction.

PATIENTS AND METHODS: In a prospective study, 16 patients with IDO and 14 with NDO resistant to anticholinergic treatment were injected with 500 U of Dysport into the detrusor. Clinical, urodynamic, and satisfaction assessments were performed at baseline and after BTX-A injections.

RESULTS: In IDO as well as in NDO, there was a significant increase in median maximum cystometric capacity (MCC) from 177.5 to 262.5 ml (P<0.0005) and 160 to 270 ml (P=0.001), median bladder compliance from 24.5 to 40.0 ml/cmH2O (P<0.0005) and 25.5 to 44.0 ml/cmH2O (P=0.001) and median PVR from 15 to 80 ml (P=0.001) and 15.0 to 62.5 ml (P=0.001), respectively. Median Pdet max decreased significantly from 49 to 37 cmH2O (P<0.0005) and 48.5 to 37.0 cmH2O (P=0.001), and median Pdet Qmax from 32.0 to 20.0 ml/sec (P<0.0005) and 36.0 to 21.5 ml/sec (P=0.001), respectively. The effect of BTX-A injections lasted for a median time of 5 months in both groups. Median daytime frequency, nocturia, and number of used pads decreased significantly in both groups. More than 80% of the patients were satisfied with the effect of BTX-A.

CONCLUSIONS: Patients with intractable IDO respond to intradetrusor BTX-A with a significant and comparable but temporally limited effect in urodynamic and LUTS parameters as those with NDO. The majority of patients were satisfied with treatment.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
17330289
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"