MP80-15 INCIDENCE OF ADVERSE EVENTS AFTER GREATER THAN 360 CUMULATIVE UNITS OF BOTULINUM TOXIN GIVEN WITHIN A THREE MONTH TIME PERIOD

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Neurogenic Voiding Dysfunction1 Apr 2014MP80-15 INCIDENCE OF ADVERSE EVENTS AFTER GREATER THAN 360 CUMULATIVE UNITS OF BOTULINUM TOXIN GIVEN WITHIN A THREE MONTH TIME PERIOD Nitya Abraham, Umaphorn Nuanthaisong, and Howard Goldman Nitya AbrahamNitya Abraham More articles by this author , Umaphorn NuanthaisongUmaphorn Nuanthaisong More articles by this author , and Howard GoldmanHoward Goldman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2538AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The manufacturer of Botox recommends no more than 360 cumulative units within a 3 month interval. Higher doses of Botox within 3 months can result in spread of toxin effect, potentially causing dysphagia and paralysis of respiratory muscles. The aim of this study was to determine the occurrence of all adverse events, especially life-threatening adverse events, after the injection of a cumulative dose of more than 360 units Botox within a 3 month interval. METHODS This is a retrospective cohort study of patients who received more than 360 units Botox within a 3 month interval, with at least one urologic indication for injection, between 1/1/2002 to 1/1/2013. The rate of any adverse event up to 8 days post-injection, and life-threatening adverse events up to 90 days post-injection was compared between injection sessions meeting the dosage guidelines and injection sessions exceeding the dosage guidelines. RESULTS 13 patients met study criteria. The most common urologic indication for injection of Botox was neurogenic detrusor overactivity (n=10), followed by detrusor sphincter dyssinergia (n=3), and idiopathic urgency incontinence (n=1). There were no adverse events after injection sessions falling within manufacturer recommended dosage guidelines. There were 6 adverse events out of a total of 135 (4.4%) injection sessions that exceeded manufacturer recommended dosage guidelines. These adverse events were minor and eventually resolved. There were no life-threatening adverse events in either group. CONCLUSIONS High cumulative doses of botulinum toxin A were tolerated in a retrospective cohort of patients undergoing injection for multiple indications. There were no life-threatening adverse events. Prospective studies are necessary to redefine the maximum cumulative dosage of Botox that can be safely administered within a certain time period. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e943 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Nitya Abraham More articles by this author Umaphorn Nuanthaisong More articles by this author Howard Goldman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...