Effects of Onabotulinum Toxin A Intradetrusor Injections on Urinary Symptoms and Sexual Life in Women Affected by Multiple Sclerosis: A Prospective Controlled Study

Antonella Giannantoni,Silvia Proietti,Ettore Mearini,Eleonora Salvini,Marilena Gubbiotti,Jacopo Adolfo Rossi De Vermandois,Savino M Di Stasi

doi:10.4172/2155-9562.1000427

Antonella Giannantoni, Silvia Proietti + Show 5 more

Open Access

https://doi.org/10.4172/2155-9562.1000427

Copy DOI

Abstract

Background: Voiding and sexual dysfunction in Multiple Sclerosis represent the most devastating dimensions of the disease. Pharmacological treatment of voiding dysfunction could improve sexual life in patients affected by the disease. We investigated the effects of Onabotulinum toxin A intradetrusor injections on urinary symptoms and sexual dysfunction, and on the psychological status of women affected by Multiple Sclerosis with refractory overactive bladder. Methods: 41 patients underwent neurologic and urologic clinical evaluations and were administered the Female Sexual Function Index, the Incontinence-Quality of Life questionnaire, the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale, before and six months after Onabotulinum toxin A intradetrusor injection; 21 continent females affected by the disease acted as controls. Results: At baseline, all patients were incontinent and 35/41 was sexually active, with low Female Sexual Function Index scores. Mild depression and anxiety were detected in all cases with a reduced quality of life. Six months after treatment, overactive bladder symptoms improved significantly in all patients. Arousal, lubrication, orgasm-related problems and desire alterations markedly improved, together with an improvement in anxiety, depression and quality of life. Scores of Female Sexual Function Index, Incontinence-Quality of Life questionnaire, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale remained unchanged in controls. Conclusion: Onabotulinum toxin A intradetrusor injections not only control overactive bladder symptoms in women affected by multiple sclerosis, but also significantly improve sexual life.

Highlights

Multiple Sclerosis (MS) is a relatively frequent, inflammatory autoimmune illness of the central nervous system affecting about 2.5 million people around the world, representing the most common cause of neurological disability among young adults [1]
Included patients had to be affected by OAB symptoms and detrusor overactivity (DO) refractory to conventional antimuscarinics, willing to undergo an intravesical treatment with Onabot/A injections
All the 41 patients were naïve to Onabot/A treatment and all completed the study

Summary

Introduction

Multiple Sclerosis (MS) is a relatively frequent, inflammatory autoimmune illness of the central nervous system affecting about 2.5 million people around the world, representing the most common cause of neurological disability among young adults [1]. Among MS patients, 40 to 80% of women and 50 to 90% of men have sexual dysfunction (SD) [2]. In these patients, SD may represent the most devastating dimension of the disease, as it can damage the physical ability to touch, move and communicate during sexual intercourse and can affect urinary and bowel continence during sexual activity [3]. Voiding and sexual dysfunction in Multiple Sclerosis represent the most devastating dimensions of the disease. We investigated the effects of Onabotulinum toxin A intradetrusor injections on urinary symptoms and sexual dysfunction, and on the psychological status of women affected by Multiple Sclerosis with refractory overactive bladder

Methods

Results

Discussion

Conclusion