Clinical outcomes of intravesical injections of botulinum toxin type A in patients with refractory idiopathic overactive bladder.

Abstract

The aim of the study was to estimated the clinical efficacy of intravesical injections of botulinum toxin type A (BTX-A) in refractory idiopathic overactive bladder (OAB) in the aspect of the quality of life. The potential mechanism of BTX-A actions were described. The study was performed on 22 women with idiopathic OAB who underwent intravesical injection of BTX-A. All women included in the study used oral pharmacotherapy for 6 months without satisfactory improvement. The severity of lower urinary tract symptoms due to OAB (LUTS/OAB) was assessed using King's questionnaire, and the OAB Symptom Scores (OABSS) scales developed by Blaivas and Homma. All of the questionnaires were completed by all of the women before and during a follow-up visit at 3rd-, 6th, and 9th-month after treatment. In patients with refractory idiopathic OAB a decrease in the general impact of LUTS/OAB symptoms domain of KHQ, and also the negative impact of LUTS/OAB on daily indoor/outdoor, physical and social activity were observed within 9 months follow-up after intravesical injections of BTX-A. Personal relationships also improved. Moreover, BTX-A has a positive effect on the patients emotions. Sleep difficulties and fatigue also decreased. The severity of LUTS/OAB symptoms were alleviated up to 9th month after BTX-A injections, however we observed a statistically insignificant increase of LUTS/OAB severity in 9th month after treatment. Intravesical injections of BTX-A is an effective therapy in refractory idiopathic OAB over the period of 9 months leading to significant improvement of quality of life in many aspects.