822 RANDOMIZED CONTROLLED TRIAL FOR EFFICACY OF BOTULINUM TOXIN TYPE A IN TREATMENT OF PATIENTS SUFFERING BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS WITH HUNNERS' LESIONS PRELIMINARY RESULTS

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2012822 RANDOMIZED CONTROLLED TRIAL FOR EFFICACY OF BOTULINUM TOXIN TYPE A IN TREATMENT OF PATIENTS SUFFERING BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS WITH HUNNERS' LESIONS PRELIMINARY RESULTS George Kasyan and Dmitry Pushkar George KasyanGeorge Kasyan Moscow, Russian Federation More articles by this author and Dmitry PushkarDmitry Pushkar Moscow, Russian Federation More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.912AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The etiology of bladder pain syndrome is unknown. Therefore the management of this condition is directed to pain relief, as bladder pain is believed to drive both voiding frequency and nocturia. Botulinum toxin A (BTX-A) has been shown to decrease noxious input. Recently published several studies showed efficacy of BTX-A for treatment of painful bladder. The aim of this study is to evaluate the efficacy and safety of BTX-A in patients who are suffering bladder pain syndrome with Hunners' lesions. METHODS The study was approved by University ethics committee. Seventy six female patients with BPS/IC were screened for the study. Hunners' lesions were found in 51,3% (39/76) of cases. Seven patients from 39 (17,9%) had refused to participate to the study. After signing informed consent 32 patients were randomized. The patients from Group 1 (15 patients) were given injections of 100 U of BTX-A diluted in 10 ml 0.9% NaCl. Injections were performed under spinal anesthesia through a cystoscope using a flexible needle in the trigone of bladder only. The patients from the Group 2 has got standard hydrodistention under spinal anesthesia (17 patients). Primary end points: The O'Leary–Sent symptom index and problem index scores were used for validation of subjective complaints of BPS/IC patients. Pain intensity was scored using a 10-point visual analog scale (VAS). Quality of life (QoL) was evaluated using question 8 of the International Prostate Symptoms Score. Secondary safety end points: Uroflowmetry followed by post void urine volume measurement and kidney ultrasound were done after the treatment. RESULTS The results of the study are presented in the Table 1. Clinical and urodynamic parameters before and after treatment Group 1 at Baseline (mean ± SD) Group 1 at 3 mo (mean ± SD) Group 2 at Baseline (mean ± SD) Group 2 at 3 mo (mean ± SD) p level O'Leary-Sant score for symptoms (0-20) 14.5±2.3 9.4±2.9 13.8±3.7 8.8±3.3 >0.05 O'Leary-Sant score for problems (0-16) 12.4±2.4 7.3±2.1 11.9±3.1 6.8±2.5 >0.05 VAS score 9.3±0.9 5.8±2.4 8.7±1.2 6.1±2.8 >0.05 Q'uality of life (0-6) 5.1±0.9 1.8±0.4 6.3±0.7 1.7±0.6 >0.05 Postvoid residual volume (ml) 13.1±4.3 23.2±3.3 12.3±3.6 13±2.6 >0.05 Qmax 24.2±4.6 14.6±13.1 21.9±3.8 26.9±9.8 >0.05 CONCLUSIONS Trigonal injection of 100 U BTX-A shows similar efficacy comparing to conventional bladder hydrodistention. There are no significant increase on the amount of residual urine, no decrease in urolowmtry rate and no upper urinary tract retention. Therefore, longer term follow up studies are warranted. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e335-e336 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information George Kasyan Moscow, Russian Federation More articles by this author Dmitry Pushkar Moscow, Russian Federation More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...