Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection in Patients with Detrusor Hyperactivity and Impaired Contractility
Resource
Toxins, 8(3),
Journal
Toxins
Journal Volume
8
Journal Issue
3
Pages
-
Date Issued
2016
Date
2016
Author(s)
Wang, Chung-Cheng
Lee, Cheng-Ling
Kuo, Hann-Chorng
Abstract
We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE) at baseline, two weeks, one, three, and six months after treatment were assessed. The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DHIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 +/- 4.8 months in DHIC patients and 7.2 +/- 3.3 months in OAB patients (p = 0.03). We concluded that the efficacy of intravesical onabotulinumtoxinA injection for DHIC patients was limited and short-term. Nevertheless, AEs did not increase in DHIC. Intravesical onabotulinumtoxinA might not be a good indication in patients with DHIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of onabotulinumtoxinA injection for treatment of DHIC.
Subjects
overactive bladder
underactive detrusor
onabotulinumtoxinA
SDGs
Other Subjects
botulinum toxin A; botulinum toxin A; neurotoxin; aged; Article; assessment of humans; clinical article; controlled study; detrusor hyperactivity and impaired contractility; detrusor hyperactivity and impaired contractility; drug efficacy; drug safety; hematuria; human; overactive bladder; overactive bladder symptom score; postvoid residual urine volume; retrospective study; treatment outcome; urgency severity scale; urinary tract disease; urinary tract infection; urinary urgency; urine incontinence; urine retention; urodynamics; uroflowmetry; weakness; bladder; drug effects; intravesical drug administration; middle aged; pathophysiology; Urinary Bladder, Overactive; Urinary Incontinence; very elderly; Administration, Intravesical; Aged; Aged, 80 and over; Botulinum Toxins, Type A; Humans; Middle Aged; Neurotoxins; Treatment Outcome; Urinary Bladder; Urinary Bladder, Overactive; Urinary Incontinence