Influence of two kinds of botulinum toxin A injection on the symptoms severity, bladder function and quality of life in patients with neurogenic detrusor overactivity combined with urinary incontinence

Abstract

Objective To investigate the influence of botulinum toxin A (BTX-A) injection in detrusor muscle region and detrusor muscle combined with bladder triangle region on the symptoms severity, bladder function and quality of life in patients with neurogenic detrusor overactivity (NDO) combined with urinary incontinence. Methods Sixty patients with NDO combined with urinary incontinence were chosen in the period from March 2011 to June 2017. The patients were divided into control group and observation group according to random digits table method with 30 cases each. The patients in control group were treated with detrusor muscle region BTX-A injection, and the patients in observation group were treated with detrusor muscle combined with bladder triangle region BTX-A injection. The number of urinary incontinence for every day, detrusor muscle overactivity (DO) duration, average urine volume, bladder detrusor muscle urine storage period of maximum pressure (Pdetmax), bladder compliance (BC), volume at first involuntary detrusor muscle contraction (VFIDC), quality of life of urinary incontinence (I-QOL) score and incidences of adverse reaction before and after treatment were compared between 2 groups. Results The number of urinary incontinence every day, DO duration, average urine volume, Pdetmax, BC, VFIDC and I-QOL score after treatment in observation group were significantly better than those in control group: (2.84 ± 0.56) times vs. (6.18 ± 1.22) times, (80.05 ± 9.49) s vs. (125.16 ± 12.72) s, (378.57 ± 91.03) ml vs. (255.88 ± 75.95) ml, (30.19 ± 5.47) cmH2O (1 cmH2O= 0.098 kPa) vs. (47.33 ± 7.79) cmH2O, (10.04 ± 1.71) ml/cmH2O vs. (8.09 ± 1.32) ml/cmH2O, (249.60 ± 76.19) ml vs. (195.19 ± 60.72) ml and (63.17 ± 9.60) scores vs. (54.46 ± 6.29) scores, and there were statistical differences (P 0.05). Conclusions Detrusor muscle combined with bladder triangle region BTX-A injection in patients with NDO combined with urinary incontinence relieves the symptoms severity, improves the bladder function and quality of life and not increases the adverse reactions risk. Key words: Botulinum toxins, type A; Urinary incontinence; Bladder triangle; Neurogenic detrusor overactivity