PI-LBA01 SACRAL NEUROMODULATION VERSUS ONABOTULINUMTOXINA FOR REFRACTORY OVERACTIVE BLADDER

Abstract

You have accessJournal of UrologyPlenary I - Monday1 Apr 2016PI-LBA01 SACRAL NEUROMODULATION VERSUS ONABOTULINUMTOXINA FOR REFRACTORY OVERACTIVE BLADDER Cindy L. Amundsen, Holly E. Richter, Shawn A. Menefee, Yuko M. Komesu, Lily A. Arya, W. Thomas Gregory, Deborah L. Myers, Halina M. Zyczynski, Sandip Vasavada, Tracy L. Nolen, Dennis Wallace, and Susan F. Meikle Cindy L. AmundsenCindy L. Amundsen More articles by this author , Holly E. RichterHolly E. Richter More articles by this author , Shawn A. MenefeeShawn A. Menefee More articles by this author , Yuko M. KomesuYuko M. Komesu More articles by this author , Lily A. AryaLily A. Arya More articles by this author , W. Thomas GregoryW. Thomas Gregory More articles by this author , Deborah L. MyersDeborah L. Myers More articles by this author , Halina M. ZyczynskiHalina M. Zyczynski More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , Tracy L. NolenTracy L. Nolen More articles by this author , Dennis WallaceDennis Wallace More articles by this author , and Susan F. MeikleSusan F. Meikle More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.03.123AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sacral neuromodulation and onabotulinumtoxinA are treatments for refractory urgency urinary incontinence (UUI). The objective of this study was to compare change from baseline in mean daily urgency urinary incontinence episodes (UUIE) over a 6-month period in women treated with these two therapies. METHODS We performed a randomized trial of women with refractory UUI comparing sacral neuromodulation versus intradetrusor injection of 200 U onabotulinumtoxinA. The primary outcome was change from baseline in mean daily UUIE over a 6-month period measured with a monthly 3-day diary. Secondary outcomes included quality of life, satisfaction, and adverse events. RESULTS A total of 386 women were randomly assigned; 369 were treated, and 364 were available for the primary outcome analyses. In both the intention to treat and clinical responder, primary outcome analyses, the onabotulinumtoxinA group reported significantly greater mean reduction in UUIE per day compared to the neuromodulation group. (Fig) The onabotulinumtoxinA group was significantly more likely to experience complete resolution of UUI, report greater improvements in overactive bladder symptom bother, and have higher satisfaction and endorsement scores with the assigned treatment. There were no group differences in patient global impression of improvement in bladder leakage or in bladder function. (Table) Urinary tract infections were higher in the onabotulinumtoxinA group (35% vs.11%, p<0.001). Self-catheterization was required in 8% and 2% of the onabotulinumtoxinA group at one and six months, respectively and neuromodulation device revisions/removals occurred in 3%. CONCLUSIONS Compared to sacral neuromodulation, intradetrusor injection of 200 U of onabotulinumtoxinA resulted in greater reduction in mean daily episodes of UUI, higher likelihood of complete resolution of UUI, and higher satisfaction albeit with an increased risk of urinary tract infections and need for transient catheterization. © 2016FiguresReferencesRelatedDetailsCited byGinsberg D (2016) OnabotulinumtoxinA is Preferred over Sacral Neuromodulation for Refractory Overactive BladderJournal of Urology, VOL. 197, NO. 1, (11-13), Online publication date: 1-Jan-2017. Volume 195Issue 4SApril 2016Page: e949-e950 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Cindy L. Amundsen More articles by this author Holly E. Richter More articles by this author Shawn A. Menefee More articles by this author Yuko M. Komesu More articles by this author Lily A. Arya More articles by this author W. Thomas Gregory More articles by this author Deborah L. Myers More articles by this author Halina M. Zyczynski More articles by this author Sandip Vasavada More articles by this author Tracy L. Nolen More articles by this author Dennis Wallace More articles by this author Susan F. Meikle More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...