1596 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 & Therapy II1 Apr 20101596 EFFECT OF REPEATED INTRADETRUSOR INJECTIONS OF BOTULINUM-A TOXIN ON URODYNAMICS AND CLINICAL PARAMETERS IN PATIENTS WITH REFRACTORY IDIOPATHIC DETRUSOR OVERACTIVITY Daniel Schmid, Sharmistha Roy-Guggenbuehl, Tullio Sulser, and Brigitte Schurch Daniel SchmidDaniel Schmid More articles by this author , Sharmistha Roy-GuggenbuehlSharmistha Roy-Guggenbuehl More articles by this author , Tullio SulserTullio Sulser More articles by this author , and Brigitte SchurchBrigitte Schurch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1374AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nonneurogenic urinary incontinence is partially due to OAB, which refers to the symptom complex of frequency, urgency and nocturia. OAB is related to a disorder of the storage phase of the bladder. Our former study in 240 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 66 pat. with repeated BoNT-A intradetrusor injections, 45 patients (35 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 two subsequent treatments reached from min. 4 months to max. 28 months (mean 12 months). We observed a significant increase of the MCC after every consecutive injection, as the MCC increased from a mean baseline of 245 ml to 380 ml after the first injection and to 420 ml after the second injection (p=0.04). The end filling detrusor pressure showed a significant decrease from baseline 41 cmH2O to a mean value of 34 cmH2O (first inj.) and then to 23 cmH2O (second inj.) (p=0.003). Bladder compliance improved from baseline 22 ml/cmH2O to 45 and 52 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 in this study 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. Zurich, Switzerland© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e617 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Schmid More articles by this author Sharmistha Roy-Guggenbuehl More articles by this author Tullio Sulser More articles by this author Brigitte Schurch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...