Efficacy of Botulinum Toxin A in the Treatment of Female Idiopathic Detrusor Overactivity Incontinence: Long-Term Results of a Prospective Nonrandomised Study

Abstract

Objectives Botulinum toxin A (BoNTA) was investigated for the treatment of patients with idiopathic detrusor overactivity (IDO) in whom anticholinergic drugs have failed. Methods In this open-label, prospective, controlled, nonrandomised study, 26 women (mean age: 66 yr; range: 48–84) with IDO received 100 U BoNTA (as BOTOX) as 30 injections into the detrusor, sparing the trigone and base. Clinical and urodynamic evaluations were performed before and at 4, 12, and 36 weeks after injection. Results At 4, 12, and 36 weeks postinjection, complete continence was achieved by 69%, 96%, and 73% of patients, respectively. Maximum cystometric bladder capacity and bladder compliance were significantly increased, and cystometric detrusor contractions were significantly decreased at each follow-up compared with baseline. Two patients had a postvoid residual volume >100 ml at week 4, and nine patients with urinary infections had to be treated with antibiotics. Quality of life (assessed by the King's Health Questionnaire) was significantly improved at all follow-up visits. Conclusions BoNTA appears to be an effective, safe, and well-tolerated treatment for patients with IDO in whom anticholinergic medication has failed.