Botulinum toxin A injection for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury: Multi‐institutional experience in Japan. (18th November 2014)

• Record Type: Journal Article
• Authors: Sengoku, Atsushi; Okamura, Kikuo; Kimoto, Yasusuke; Ogawa, Takatoshi; Namima, Takashige; Yamanishi, Tomonori; Yokoyama, Teruhiko; Akino, Hironobu; Maeda, Yoshiko
• Is Part Of: International journal of urology. Volume 22:Number 3(2015)
• Page Start: 306
• Page End: 309
• Publication Date: 2014-11-18
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12668
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12668-sec-0001" sec-type="section"> <title>Objectives</title> <p>To examine the efficacy and safety of onabotulinumtoxinA (Botox) injection into the bladder wall for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury in Japanese patients.</p> </sec> <sec id="iju12668-sec-0002" sec-type="section"> <title>Methods</title> <p>We enrolled Japanese spinal cord injury patients with cystometrically confirmed neurogenic detrusor overactivity who experienced urinary incontinence at least once a week either because they were refractory to anticholinergics or had to discontinue treatment because of adverse events. Patients received 200 units of onabotulinumtoxinA injected into the bladder wall after a 2‐week washout of anticholinergics, and urodynamic variables were assessed before and 1 month after injection. Catheterization and urinary incontinence data, as well as International Consultation on Incontinence Questionnaire – Short Form scores, were assessed before injection and every month thereafter until the cessation of treatment effects.</p> </sec> <sec id="iju12668-sec-0003" sec-type="section"> <title>Results</title> <p>The study enrolled 19 patients (13 men, six women, age range 22–67 years). One month after injection, the mean number of urinary incontinence episodes decreased from 4.3 to 1.5 times/day (<italic>P</italic> = 0.004), and the maximum cystometric capacity increased from 100 mL to 296 mL (<italic>P</italic> = 0.0004). The rate of effective cases whose daily urinary incontinence frequency was decreased to less than 50% was 74%. The duration of efficacy without anticholinergic medication ranged from 3 to 12 months (median 8.5 months). Clinically significant adverse events were not observed.</p> </sec> <sec id="iju12668-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The present findings show the efficacy and tolerability of onabotulinumtoxinA injection for the treatment of neurogenic detrusor overactivity in Japanese spinal cord injury patients.</p> </sec> </abstract>