You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2011945 PERSISTENT THERAPEUTIC EFFECT OF REPEATED INJECTIONS OF ONABOTULINUM TOXIN A IN REFRACTORY BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS Rui Pinto, Tiago Lopes, João Silva, Carlos Silva, Francisco Cruz, and Paulo Dinis Rui PintoRui Pinto Porto, Portugal More articles by this author , Tiago LopesTiago Lopes Porto, Portugal More articles by this author , João SilvaJoão Silva Porto, Portugal More articles by this author , Carlos SilvaCarlos Silva Porto, Portugal More articles by this author , Francisco CruzFrancisco Cruz Porto, Portugal More articles by this author , and Paulo DinisPaulo Dinis Porto, Portugal More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.890AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the persistence of the therapeutic effect of repeated intra-trigonal injection of Onabotulinum toxin A in patients with Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) refractory to first line treatment. METHODS Fourteen women with BPS/IC refractory to first line treatment received 4 consecutive intra-trigonal injections of Onabotulinum toxin A. Patients were treated under general anaesthesia. With a rigid cystoscope, 100 U of Onabotulinum toxin A were injected in 10 trigonal sites, each receiving 10 U in 1 ml of saline. All patients were discharged under prophylactic antibiotic. The therapeutic effect was evaluated by a 3-day voiding chart, O'Leary-Sant Score (OSS), QoL from IPSS, and by pain visual analogue scale (0–10) before treatment and every 3 months after each injection. Voiding dysfunction and urinary tract infections (UTIs) were accessed every 3 months. Duration of each injection was determined by the moment patients requested another treatment. RESULTS Patients had a mean age of 42 y, and a BPS/IC ESSIC classification of 2a (1), 2b (1), 2c (4), 3a (1), 3b (2) and 3c (5). Mean values at baseline were: pain score, 5.9±1.8; urinary frequency, 16.4±5.3; OSS, 28.8±6.3; and QoL, 5±0.9. All patients reported subjective improvement following each injection. Decreases in pain score, urinary frequency, OSS and QoL after each treatment are shown in Table 1. Each treatment provided symptomatic relief for a period between 9–10 months. No cases of voiding dysfunction were reported and 5 patients had UTIs after Onabotulinum toxin A injection (2 after 2nd treatment, 1 after 3rd treatment and 2 after 4th treatment). Table 1. Decrease of pain score, urinary frequency, OSS and QoL at 3 months visit after each injection and mean duration of each treatment. Pain Score (variation) Frequency (variation) OSS (variation) Qol (variation) Mean duration (months) 1st injection −3.2±0.8 −6.6±0.5 −12.7±1.8 −4.0±1.0 10.1±2.4 2nd injection −3.3±0.5 −5.7±0.7 −10.9±2.8 −3.8±1.3 10.3±2.2 3rd injection −2.9±0.6 −5.2±1.2 −9.4±3.7 −3.4±1.5 9.3±2.7 4th injection −2.7±0.7 −5.3±0.9 −10.3±3.8 −3.5±1.1 9.8±3.2 CONCLUSIONS This study suggests that intra-trigonal injection of 100 U of Onabotulinum toxin A is safe, effective and has maintained effect after repeated injections in refractory BPS/IC. Mean duration of the symptomatic improvement was superior to 9 months after treatment. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e379 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rui Pinto Porto, Portugal More articles by this author Tiago Lopes Porto, Portugal More articles by this author João Silva Porto, Portugal More articles by this author Carlos Silva Porto, Portugal More articles by this author Francisco Cruz Porto, Portugal More articles by this author Paulo Dinis Porto, Portugal More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...