MP48-13 PROSPECTIVE EVALUATION OF INTRADETRUSOR INJECTIONS OF ONABOTULINUMTOXINA IN ADULTS WITH SPINAL DYSRAPHISM

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP48)1 Apr 2020MP48-13 PROSPECTIVE EVALUATION OF INTRADETRUSOR INJECTIONS OF ONABOTULINUMTOXINA IN ADULTS WITH SPINAL DYSRAPHISM Alexander Mackay*, Rachel Sosland, Khue Tran, Julie Stewart, Timothy Boone, and Rose Khavari Alexander Mackay*Alexander Mackay* More articles by this author , Rachel SoslandRachel Sosland More articles by this author , Khue TranKhue Tran More articles by this author , Julie StewartJulie Stewart More articles by this author , Timothy BooneTimothy Boone More articles by this author , and Rose KhavariRose Khavari More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000903.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: OnabotulinumtoxinA (BTX-A) injection is a well-established management strategy in the treatment of patients with neurogenic overactive bladder (NOAB). Few studies, however, have investigated the treatment effects of BTX-A in adult patients with congenital spinal dysraphism (CSD), despite the fact that sustained pathologic bladder conditions may render BTX-A less effective. Furthermore, there are no recommendations regarding urodynamics (UDS) evaluation to monitor patients with spinal dysraphism following injection of BTX-A. The objective of this study is to report both subjective changes in outcomes and objective changes in urodynamic parameters after intra-detrusor injections of BTX-A in adults with CSD. METHODS: This study is a prospective, nonrandomized clinical trial which is currently enrolling. Seventeen adults with CSD and NOAB have been enrolled beginning in March 2019. Target enrollment is 20 patients (anticipation of study completion is December 2019). Patients are evaluated at baseline with (video) UDS and validated questionnaires, and then again at 1-3 months following injection of BTX-A. RESULTS: Of the 17 participants enrolled to date, nine have completed baseline UDS, BTX-A injection, and post-injection UDS. Of the patients enrolled, 60% are female with a mean age of 26 (range 20-35), and 66% of patients are non-ambulatory. Preliminary results, for those who have completed the study, show a mean total score on I-QOL Feelings Score before and after treatment is significantly improved (53.79 vs. 61.24, p= 0.037). Results of the Neurogenic Bladder Symptom Score before and after treatment showed significant improvement in incontinence (17.33 vs 13.56, p = 0.037) and Quality of Life (QOL) 2.44 vs 1.44 (p= 0.009). Neither mean maximum cystometric capacity (292.3 vs. 283.2, p= 0.899) nor mean bladder compliance (43.2 vs. 81.6, p= 0.075) is significantly different following injection. CONCLUSIONS: A prospective evaluation of BTX-A in adults with CSD is needed to determine the optimal treatment in this understudied population. Initial findings show BTX-A injection may improve refractory urinary incontinence and quality of life in adults with CSD. While subjectively patients may feel improved, preliminary data does not reflect significant improvement in objective UDS parameters. Additional data are needed to determine if BTX-A injection is as effective in adult patients with CSD compared to other etiologies of NOAB. Source of Funding: Funding has been provided from an internal Houston Methodist Specialty Physician Group Performance Grant for 2019. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e699-e699 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Mackay* More articles by this author Rachel Sosland More articles by this author Khue Tran More articles by this author Julie Stewart More articles by this author Timothy Boone More articles by this author Rose Khavari More articles by this author Expand All Advertisement PDF downloadLoading ...