1008 EFFECT OF REPEATED INTRADETRUSOR INJECTIONS OF BOTULINUM-A TOXIN ON URODYNAMICS AND CLINICAL PARAMETERS IN PATIENTS WITH REFRACTORY IDIOPATHIC DETRUSOR OVERACTIVITY

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence: Evaluation & Therapy1 Apr 20111008 EFFECT OF REPEATED INTRADETRUSOR INJECTIONS OF BOTULINUM-A TOXIN ON URODYNAMICS AND CLINICAL PARAMETERS IN PATIENTS WITH REFRACTORY IDIOPATHIC DETRUSOR OVERACTIVITY Daniel Max Schmid, Sharmistha Roy-Guggenbuehl, Rachel Groebli-Bolleter, and Tullio Sulser Daniel Max SchmidDaniel Max Schmid Zurich, Switzerland More articles by this author , Sharmistha Roy-GuggenbuehlSharmistha Roy-Guggenbuehl Zollikerberg, Switzerland More articles by this author , Rachel Groebli-BolleterRachel Groebli-Bolleter Zurich, Switzerland More articles by this author , and Tullio SulserTullio Sulser Zurich, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1042AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Our former study in 250 pat. shows that a first BoNT-A injection increased maximum cystometric capacity (MCC) and reduced clinical symptoms as urgency, frequency and incontinence. As we lacked knowledge of urodynamic effects of repeated injections, we evaluated in this study urodynamic parameters of consecutive BoNT-A injections in the detrusor muscle in patients with idiopathic OAB resistant to conventional treatment, who needed a second BoNT-A treatment after loss of efficacy of their first injection. METHODS Out of 73 pat. with repeated BoNT-A intradetrusor injections, 50 patients (40 women and 10 men) with relapsing symptoms of OAB underwent clinical checks and standard urodynamic studies before and 12 weeks after their first and second injection, respectively. We compared then the urodynamic parameters measured at baseline and after two consecutive injections of 100 U of BoNT-A. RESULTS The interval between 2 subsequent treatments reached from min. 4 mths. to max. 28 mths. (mean 12 mths.). We observed a significant increase of the MCC after every consecutive injection, as the MCC increased from a mean baseline of 240 ml to 385 ml after the first injection and to 425 ml after the second injection (p=0.04). The end filling detrusor pressure showed a significant decrease from baseline 40 cmH2O to a mean value of 34 cmH2O (first inj.) and then to 24 cmH2O (second inj.) (p=0.003). Bladder compliance improved from baseline 22 ml/cmH2O to 45 and 51 ml/cmH2O (p=0.0001), respectively. All our patients reported reduced OAB symptoms after treatments, and comparing quality of life, we saw no significant differences between a first and a consecutive injection. CONCLUSIONS Besides the well known efficacy of BoNT-A injections in pat. with refractory idiopathic OAB, we observed a continuous improvement of urodynamic parameters after consecutive treatments; in particular, bladder compliance even increased after a second treatment, banishing some former concern, that repeated injections could negatively affect bladder wall structure. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e406 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Max Schmid Zurich, Switzerland More articles by this author Sharmistha Roy-Guggenbuehl Zollikerberg, Switzerland More articles by this author Rachel Groebli-Bolleter Zurich, Switzerland More articles by this author Tullio Sulser Zurich, Switzerland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...