Faculty Collaboration Database

Use of botulinum-A toxin for the treatment of refractory overactive bladder symptoms: an initial experience. Urology 2004 Jun;63(6):1071-5

Date

06/09/2004

Pubmed ID

15183952

DOI

10.1016/j.urology.2004.01.041

Scopus ID

2-s2.0-2942613330 (requires institutional sign-in at Scopus site)   139 Citations

Abstract

OBJECTIVES: To define the role of botulinum toxin type A (botulinum-A) intradetrusor injections in the treatment of patients with symptoms of bladder overactivity in whom previous anticholinergic therapy has failed.

METHODS: Thirty-five patients (29 women and 6 men) with frequency, urgency, and/or urge incontinence received 300 U of botulinum-A toxin injected transurethrally at 30 sites within the bladder. Patients were evaluated at 3 weeks and 6 months after treatment by completion of the short forms of the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6), as well as questions assessing global response to the treatment.

RESULTS: After 3 weeks, the mean IIQ-7 score decreased from 19.4 to 13.9 (P = 0.0006) and the mean UDI-6 score decreased from 16.8 to 12.8 (P = 0.0003). Overall, 21 (60%) of 35 patients reported slight to complete improvement of voiding symptoms after 3 weeks. Among the initial responders followed up for 6 months, the mean IIQ-7 score improved from 20.6 to 15.1 (P = 0.008) and the mean UDI-6 score improved from 16.9 to 13.5 (P = 0.008). Mild hematuria, pelvic pain, and dysuria were seen in 7 patients, lasting for 3 days or less after the procedure.

CONCLUSIONS: Botulinum-A toxin injections may provide improvement in symptoms associated with bladder overactivity in a subset of patients. Improvement may be seen for at least 6 months after treatment. The procedure was well tolerated with minimal side effects. Additional study to define the role of injections in a broad group of patients with irritative voiding symptoms is warranted.

Author List

Rapp DE, Lucioni A, Katz EE, O'Connor RC, Gerber GS, Bales GT

Author

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

Adult
Aged
Aged, 80 and over
Botulinum Toxins, Type A
Female
Follow-Up Studies
Humans
Male
Middle Aged
Treatment Outcome
Urinary Bladder Diseases
Urinary Incontinence