MP85-16 COMPARISON OF URODYNAMIC PARAMETERS FOLLOWING INJECTION OF TWO DIFFERENT BOTULINUM TOXIN A PREPARATIONS IN MANAGEMENT OF NEUROGENIC DETRUSOR OVER-ACTIVITY FOLLOWING SPINAL CORD INJURY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2017MP85-16 COMPARISON OF URODYNAMIC PARAMETERS FOLLOWING INJECTION OF TWO DIFFERENT BOTULINUM TOXIN A PREPARATIONS IN MANAGEMENT OF NEUROGENIC DETRUSOR OVER-ACTIVITY FOLLOWING SPINAL CORD INJURY Jason Gan, Sarah Rasip, Sarah Knight, Mohamed Helal, Frank Lee, Julian Shah, and Rizwan Hamid Jason GanJason Gan More articles by this author , Sarah RasipSarah Rasip More articles by this author , Sarah KnightSarah Knight More articles by this author , Mohamed HelalMohamed Helal More articles by this author , Frank LeeFrank Lee More articles by this author , Julian ShahJulian Shah More articles by this author , and Rizwan HamidRizwan Hamid More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2678AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Following spinal cord injury (SCI), disruption to neuronal pathways of the bladder can lead to neurogenic detrusor over-activity (NDO) causing reduced capacity, high pressure and incontinence. Intra-detrusor injections of botulinum toxin A (BTX-A) are commonly used to manage these complications. Between 2013-2014 our department changed from using abobotulinum toxin (aboBTX) (750-1000 u) to onabotulinum toxin (onaBTX) (200 u). We have analysed the urodynamic outcomes and patient satisfaction to determine the relative efficacy of the two drugs on NDO following SCI. METHODS The medical notes of 171 patients receiving consecutive doses of aboBTX and onaBTX during 2013-2014 were reviewed. 36 SCI patients with NDO and urodynamics within 6 months of injection of both aboBTX and onaBTX were included. The maximum cystometric capacity (MCC) and maximum detrusor pressure (MDP) were recorded. Paired t-tests were performed to test difference in bladder function between the two BTX-A drugs. RESULTS The post-injection mean (± SD) MCC for aboBTX was 375 ± 178 ml and for onaBTX was 378 ± 212 ml. The post injection mean (± SD) MDP for aboBTX was 25 ± 21 cmH2O and for onaBTX was 27 ± 18 cmH2O. There was no significant difference between MCC (p=0.5) and MDP (p=0.86) for each drug. The scatter graphs demonstrate the relationship between the preparations with respect to MCC and MDP. The solid line represents the linear regression and the dashed line represents a 1:1 relationship. The linear regression for MCC had a slope of 1 demonstrating a clear correlation between the bladder capacity after aboBTX and onaBTX. There was not such a clear correlation between the MDP data. 12 out of 36 patients reported worse satisfaction with onaBTX than aboBTX, though interestingly this did not correlate with worse urodynamic outcomes. CONCLUSIONS There was no statistically significant difference in objectively measured urodynamic parameters of bladder function between aboBTX and onaBTX in patients with NDO following SCI. However 1/3 of patients reported worse satisfaction with onaBTX. The data will be further analysed to compare the efficacy of repeated injections and the effect of prior exposure to each agent. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1154 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jason Gan More articles by this author Sarah Rasip More articles by this author Sarah Knight More articles by this author Mohamed Helal More articles by this author Frank Lee More articles by this author Julian Shah More articles by this author Rizwan Hamid More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...