Botulinum Toxin A Intradetrusor Injection for Treating Neurogenic Detrusor Overactivity, A Single Centre Experience. Issue 3 (24th October 2013)

• Record Type: Journal Article
• Authors: MOSLI, Hisham A.; AWAD, Mohannad A.; REZK, Mamdouh M.; ALSABBAN, Abdulrahman E.; TAYIB, Abdulmalik M. S.; ABDULWAHAB, Mohammed H.; ASSIRI, Moayad A.
• Is Part Of: LUTS. Volume 6:Issue 3(2014)
• Page Start: 162
• Page End: 166
• Publication Date: 2013-10-24
• Subjects: Urology -- Periodicals; Urologic Diseases -- Periodicals; Urinary Tract Physiological Phenomena -- Periodicals; 616.62
• DOI: 10.1111/luts.12034
• Languages: English
• ISSNs: 1757-5664

Abstract

<abstract abstract-type="main" id="luts12034-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="luts12034-sec-0001" sec-type="section"> <title>Objectives</title> <p id="luts12034-para-0001">To evaluate the efficacy and safety of Botulinum Toxin A (BoNTA) intradetrusor injections in patients with neurogenic detrusor overactivity.</p> </sec> <sec id="luts12034-sec-0002" sec-type="section"> <title>Methods</title> <p id="luts12034-para-0002">All patients provided clinical history and voiding diary, submitted to clinical examination, urine culture; serum creatinine; imaging, including plain abdominal X‐rays, abdomino‐pelvic ultrasonography and voiding cystourethrogram; and urodynamic tests (CMG) . They were managed by intradetrusor injections of BoNTA. For the typical patient, 300 units of BoNTA were injected through 30 injections of 10 u/mL intradetrusally into equally spaced sites of the bladder wall, excluding the trigone, under cystoscopic guidance. Patients were commenced clean intermittent catheterizations (CICs) every 4–6 h post‐injection. Follow up included voiding diaries, abdomino‐pelvic ultrasonography, serum creatinine and CMG, were completed for all patients at 6 and 12 weeks. This study used IBM SPSS Version 20.0 for statistical analysis.</p> </sec> <sec id="luts12034-sec-0003" sec-type="section"> <title>Results</title> <p id="luts12034-para-0003">Forty‐five patients (28 males and 17 females) with a mean age of 19.6 years were subjected to BoNTA intradetrusor injections. A good clinical response (dry patient either completely or more than 50% of the period between CICs) was observed in 68.9 and 66.7% of the patients after 6 and 12 weeks of follow up, respectively. In the group that responded well, the mean bladder volume increased post‐injection by 48.2% and the mean maximum intravesical pressure decreased to 35.3 cm H<sub>2</sub>O, a 33.4% improvement. No patients had side‐effects related to BoNTA or to the procedure, and no patients experienced a deterioration of their renal functions.</p> </sec> <sec id="luts12034-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="luts12034-para-0004">Intradetrusor BoNTA injections provide a good clinical response. The urodynamic parameters significantly improved in patients with neurogenic detrusor overactivity.</p> </sec> </abstract>