Diabetes Mellitus Does Not Affect the Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection in Patients With Refractory Detrusor Overactivity
Resource
Neurourol. Urodyn., 33(8), 1235-1239
Journal
Neurourol. Urodyn.
Journal Volume
33
Journal Issue
8
Pages
1235-1239
Date Issued
2014
Date
2014
Author(s)
Wang, Chung-Cheng
Liao, Chun-Hou
Kuo, Hann-Chorng
Abstract
AimsTo investigate the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with diabetes mellitus (DM) and refractory detrusor overactivity (DO). ;MethodsForty-eight type 2 DM patients with refractory DO received intravesical 100U onabotulinumtoxinA injection. Another 48 age-matched patients were randomly selected from a non-diabetic group as controls. Video-urodynamic studies were performed at baseline and were repeated 3 months after treatment. The treatment outcomes were graded on the basis of changes in the Patient's Perception of Bladder Condition (PPBC) and a PPBC decrease of 2 or more points was considered successful. Treatment-related adverse events including acute urinary retention, large post-voiding residual (PVR) volumes, straining to void, urinary tract infection, hematuria, and general weakness were recorded. ;ResultsThe mean ages of the diabetic and non-diabetic patients were 73.18.8 and 72.0 +/- 9.3 (P=0.552), respectively. The changes of urodynamic parameters were comparable between the two groups. Similar successful results were noted at the 6-month follow-up (DM, 56% vs. non-DM, 61%, P=0.128). Diabetic patients had a significantly greater incidence of large PVR volumes (DM, 60.4% vs. non-DM, 33.3%; P=0.007) and general weakness (DM, 10.4% vs. non-DM, 0%; P=0.03) after treatment. Baseline urodynamic parameters in diabetic patients did not predict the occurrence of adverse events. No major complication was noted in either group. ;ConclusionsIntravesical onabotulinumtoxinA injection is a safe and effective treatment for DM patients with refractory DO. Patients with DM should be informed of the increased risk of large PVR before initiation of treatment. Neurourol. Urodynam. 33:1235-1239, 2014. (c) 2013 Wiley Periodicals, Inc.
Subjects
botulinum toxin
detrusor overactivity
diabetes
SDGs
Other Subjects
botulinum toxin A; hemoglobin A1c; insulin; botulinum toxin A; aged; Article; clinical article; comparative study; controlled study; diabetic patient; drug efficacy; drug safety; female; Foley balloon catheter; follow up; hematuria; hemoglobin blood level; human; insulin treatment; male; named inventories, questionnaires and rating scales; non insulin dependent diabetes mellitus; overactive bladder; Patient Perception of Bladder Condition; postvoid residual urine volume; side effect; treatment outcome; urinary tract infection; urine retention; urodynamics; weakness; complication; controlled clinical trial; intravesical drug administration; non insulin dependent diabetes mellitus; retrospective study; Urinary Bladder, Overactive; Administration, Intravesical; Aged; Botulinum Toxins, Type A; Diabetes Mellitus, Type 2; Female; Humans; Male; Retrospective Studies; Treatment Outcome; Urinary Bladder, Overactive