Botulinum toxin type A in patients with Parkinson's disease and refractory overactive bladder

Antonella Giannantoni, Antonella Conte, Silvia Proietti, Silvia Giovannozzi, Aroldo Rossi, Giovanni Fabbrini, Massimo Porena, Alfredo Berardelli
Journal of Urology 2011, 186 (3): 960-4

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.

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