Faculty Collaboration Database

Botulinum toxin outcomes for idiopathic overactive bladder stratified by indication: lack of anticholinergic efficacy versus intolerability. Neurourol Urodyn 2011 Nov;30(8):1538-40

Date

08/10/2011

Pubmed ID

21826718

DOI

10.1002/nau.21150

Scopus ID

2-s2.0-80054826699 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

AIMS: To determine if the outcomes of intradetrusor botulinum toxin A (BTX-A) injections for the management of refractory overactive bladder (OAB) symptoms are different if performed due to lack of anticholinergic efficacy versus medication intolerability.

METHODS: Retrospective chart review was performed on all patients undergoing intradetrusor BTX-A (BOTOX®, Allergan Inc., Irvine, CA) injections from 2004 to 2010 for the management of refractory idiopathic OAB with or without urge incontinence. All patients failed anticholinergic medications due to either lack of efficacy or intolerable side effects. Patient outcomes following BTX-A injections (150-200 units) were compared based on the primary reason for discontinuing anticholinergic medications (lack of efficacy vs. intolerability). Successful BTX-A injections were defined as those producing symptomatic OAB improvement warranting future repeat injections upon return of symptoms.

RESULTS: A total of 85 patients were included in the study. Overall, 58/85 (68%) reported symptomatic improvement following BTX-A injections. Successful outcomes were reported in 34/57 (60%) patients treated secondary to lack of anticholinergic efficacy versus 24/28 (86%) due to intolerable side effects (P = 0.02).

CONCLUSIONS: BTX-A injections are more successful in patients with anticholinergic intolerability as compared to patients with poor medication efficacy (86% vs. 60%, P = 0.02).

Author List

Makovey I, Davis T, Guralnick ML, O'Connor RC

Authors

Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

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

Administration, Intravesical
Adult
Aged
Aged, 80 and over
Anticholesteremic Agents
Botulinum Toxins, Type A
Drug Resistance
Female
Humans
Male
Middle Aged
Neuromuscular Agents
Patient Selection
Retrospective Studies
Time Factors
Treatment Failure
Urinary Bladder, Overactive
Wisconsin