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Intradetrusor botulinum toxin injections (300 units) for the treatment of poorly compliant bladders in patients with adult neurogenic lower urinary tract dysfunction. Neurourol Urodyn 2020 Nov;39(8):2322-2328

Date

09/01/2020

Pubmed ID

32866304

DOI

10.1002/nau.24490

Scopus ID

2-s2.0-85089961662 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

AIMS: To evaluate the therapeutic effects of intradetrusor onabotulinum toxin A (BTX) injections in patients with adult neurogenic lower urinary tract dysfunction (ANLUTD) and medically refractory poorly compliant bladders.

METHODS: We retrospectively evaluated patients with urodynamic studies (UDS)-proven, medically refractory impaired bladder compliance (≤20 mL/cm H2 O) secondary to spinal myelopathy treated with 300 units of BTX cystoscopically injected into the detrusor muscle. Objective improvement in compliance was defined as an increase ≥5 mL/cm H2 O on repeat urodynamics. Characteristics were compared between patients who demonstrated symptomatic and objective improvement following treatment versus those without.

RESULTS: Seventy-one individuals were included in the final analysis. Mean patient age was 37.2 years (range: 18-78) and ANLUTD duration was 14.5 years (range: 1-34). Average pre-injection bladder compliance was 9.2 mL/cm H2 O (range: 3.0-16.7). After treatment with BTX, 37 of 71 (52%) patients reported subjective reductions in lower urinary tract symptoms. Repeat UDS demonstrated objective bladder compliance improvements in 22 of 71 (31%). Individuals with shorter time intervals since neurologic injury responded better to BTX than those with longer durations (P = .032).

CONCLUSION: BTX injections significantly improved symptoms and bladder compliance in 31% of ANLUTD patients with medical refractory poorly compliant bladders.

Author List

O'Connor RC, Johnson DP, Guralnick ML

Author

Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Botulinum Toxins, Type A
Female
Humans
Injections, Intramuscular
Male
Middle Aged
Neuromuscular Agents
Patient Compliance
Retrospective Studies
Treatment Outcome
Urinary Bladder, Neurogenic
Urodynamics
Young Adult