1972 THE ZURICH EXPERIENCES INCLUDING 10 YEAR RESULTS OF 253 CASES TREATED WITH BOTULINUM-A TOXIN INJECTIONS INTO THE DETRUSOR MUSCLE FOR OVERACTIVE BLADDER REFRACTORY TO ANTICHOLINERGICS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-Neurogenic Voiding Dysfunction1 Apr 20121972 THE ZURICH EXPERIENCES INCLUDING 10 YEAR RESULTS OF 253 CASES TREATED WITH BOTULINUM-A TOXIN INJECTIONS INTO THE DETRUSOR MUSCLE FOR OVERACTIVE BLADDER REFRACTORY TO ANTICHOLINERGICS Daniel Max Schmid, Sharmistha Roy-Guggenbuehl, 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 , and Tullio SulserTullio Sulser Zurich, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2131AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Aim of this prospective study was to evaluate the efficacy and long-term results of low-dose (100 U) Botulinum-A toxin (BoNT-A) injections into the detrusor to treat patients suffering from severe non-neurogenic overactive bladder (OAB). METHODS 253 patients (68 m, 185 f; mean age 57 y., 18-87 y.) were treated by injections of 100 U of BoNT-A. Micturition diary, urodynamics, and neurological status were performed before treatment. Clinical and urodynamic checks and quality of life assessment (QoL) were performed at baseline and 12 weeks after BoNT-A treatment. Follow-up included duration of effect, re-injection rate and intervals between treatments. RESULTS Overall, 83 % of patients showed a significant (p<0.001) improvement of their bladder function in regard to symptoms as well as to urodynamic parameters Urgency completely disappeared in 75% and incontinence in 85% within 2 weeks, whereas daily pad usage dropped from 5 to 0.5 pads/day. Frequency decreased from 16 to 7 micturitions and nocturia from 5 to 2.5 (-50%), respectively. MCC increased from mean 230 to 395 ml (+71%), BC rised from 20 to 44 ml/cmH2O. FDV increased from mean 120 to 215 ml. There were no severe side effects except 7 temporary urine retentions and 20 urinary infections. QoL assessment revealed a significant subjective improvement in all urge-related items. In 16 patients clinical benefit was poor due to preop. low compliance. Efficacy duration was mean 8 (+/−2) months. So far, 29% (74/253) of patients were reinjected after the effect had diminished. The time interval between two treatments was mean 13 months (2-50). 21 patients had a third BoNT-A injection and we observed a longer lasting effect of mean + 5 months between the second and third treatment compared to the interval between the first and second treatment.13 pat. had 4 and 1 had 9 injections and urodynamic changes and clinical efficacy were similar to the first treatment. 27.5% of pat. had no further therapy, 40% take ACh. and 3.5% (n=9) underwent SNS. We observed no deterioration of bladder function even after repeated injections. CONCLUSIONS Our results show, that detrusor BoNT-A-injections are an efficient and safe treatment in patients suffering from severe OAB. Overlooking a follow-up time of 10.5 years, we are able to define a relaps rate of 29% after 13 months and an increasing symptom free time in patients undergoing repeated injections. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e795-e796 Advertisement Copyright & Permissions© 2012 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 Tullio Sulser Zurich, Switzerland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...