MP77-07 SAFETY AND EFFICACY OF BOTULINUM TOXIN A TREATMENT FOR PATIENTS WITH DETRUSOR OVERACTIVITY AND INADEQUATE CONTRACTILITY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II1 Apr 2016MP77-07 SAFETY AND EFFICACY OF BOTULINUM TOXIN A TREATMENT FOR PATIENTS WITH DETRUSOR OVERACTIVITY AND INADEQUATE CONTRACTILITY Shu-Yu Wu, Chung-Cheng Wang, and Hann-Chorng Kuo Shu-Yu WuShu-Yu Wu More articles by this author , Chung-Cheng WangChung-Cheng Wang More articles by this author , and Hann-Chorng KuoHann-Chorng Kuo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1921AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Botulinum toxin A (BoNT-A) significantly improves OAB symptoms and urodynamic parameters. However, increased PVR volume and risk of urinary tract infection (UTI) after treatment remain concerns among frail elderly patients. This study retrospectively analyzed the therapeutic efficacy and safety in OAB patients who had a baseline PVR >100 mL or VE <67% and received intravesical BoNT-A 100 U injections. METHODS A total of 21 patients with urodynamically proven DHIC and 21 age-matched controlled patients with urodynamic DO were selected from our previous clinical trials. Patients with DHIC should have a PVR of >100 mL but <250 mL, or a VE of less than 67% (voided volume <67% of maximal bladder capacity) at baseline. Patients with DO should have a PVR<50 mL and VE >67% at baseline. Patients were treated with suburothelial injections of 100 U BoNT-A (Allergan, Irvine, CA, USA) in 10 mL, 0.5 mL in each injection, total 20 injections in the bladder body, sparing the trigone. All patients were evaluated at baseline, 2 weeks, and 1, 3, and 6 months after treatment. Treatment results were assessed with global response assessment (GRA), OAB symptom score (OABSS), USS, patient perception of bladder condition (PPBC), and voiding diary parameters. Procedure-related AEs were recorded during the follow-up period after BoNT-A treatment. RESULTS The mean age of DHIC and OAB patients were 71.2±8.2 and 70.9±14.1 years, respectively. The changes of measured parameters from baseline to 6 months in the two groups. The subjective symptom scores after BoNT-A all showed significantly improved in both groups and no difference between groups. However, the changes of urgency episodes per 3 days were only noted in OAB patients after BoNT-A injection. UUI was significantly improved at 3 months and frequency episode was significantly improved at 6 months in OAB patients, but not in DHIC patients. Interestingly, there was no increase of bladder capacity or voided volume in either group. Qmax showed no significant change after BoNT-A injection in either group. PVR increased in DHIC patients at 2 and 4 weeks, but not at 3 and 6 months after BoNT-A injection. However, in OAB patients, the significant increase of PVR was noted at 2 months and lasted to 6 months. Adverse events in the DHIC and OAB patients showed no significant difference between DHIC and OAB. Among these patients, the therapeutic efficacy lasted for a mean of 2.3 months and 4.5 months in DHIC and OAB patients, respectively. CONCLUSIONS Patients with DHIC do not increase the risk of large PVR or decrease of VE after 100 U BoNT-A injection. However, the therapeutic efficacy was significantly diminished in DHIC patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1018 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Shu-Yu Wu More articles by this author Chung-Cheng Wang More articles by this author Hann-Chorng Kuo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...