https://scholars.lib.ntu.edu.tw/handle/123456789/550181
標題: | Factors associated with therapeutic efficacy of intravesical onabotulinumtoxina injection for overactive bladder syndrome | 作者: | Hsiao S.-M. HO-HSIUNG LIN Kuo H.-C. |
公開日期: | 2016 | 出版社: | Public Library of Science | 卷: | 11 | 期: | 1 | 起(迄)頁: | 147137 | 來源出版物: | PLoS ONE | 摘要: | Objectives To analyze the predictors of therapeutic efficacy after intravesical botulinum toxin A injection for overactive bladder syndrome (OAB) refractory to antimuscarinic therapy. Methods All consecutively OAB patients, who visited the urologic outpatient clinics of a medical center and refractory to antimuscarinic treatment, were prospectively enrolled. All enrolled patients received intravesical injection of 100 U onabotulinumtoxinA (Botox). The Global Response Assessment (GRA) score ? 2 at 3 months after Botox injection was defined as a successful treatment, otherwise failed. Results Overall, 89 patients received intravesical injection. Eighty patients, including 42 men and 38 women, had received follow-up at 3 months. The overall success rate was 63.8%. The global response assessment, urgency severity score, urgency, urgency urinary incontinence and frequency episodes, and functional bladder capacity improved after treatment. However, post-void residual volume (PVR) increased, and voiding efficiency (VE) decreased after treatment. Female gender (odds ratio = 3.75) was the only independent factor associated with the success. Female gender (coefficient = 0.74), low baseline overactive bladder symptoms score (coefficient = -0.12) and the presence of OAB-wet (coefficient = 0.79) were independent factors associated with therapeutic efficacy (i.e., GRA score). VE (odds ratio = 0.062) was the only predictor for a large PVR at 3 months. The optimum cutoff value of VE was <87%with the area under the ROC curve being 0.64 (sensitivity = 63.8%, specificity = 57.1%). Conclusions The therapeutic effects of Botox can persist till 6 months after treatment. Female gender, low overactive bladder symptoms score and OAB-wet are associated better therapeutic efficacy, and low baseline VE is associated with large PVR. These findings can serve as an initial guide or assist in consultation regarding the treatment of OAB patients with Botox injection. ? 2016 Hsiao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84959020799&doi=10.1371%2fjournal.pone.0147137&partnerID=40&md5=a4bf66df527b36de2affdb32b50917da https://scholars.lib.ntu.edu.tw/handle/123456789/550181 |
ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0147137 | SDG/關鍵字: | botulinum toxin A; acetylcholine release inhibitor; botulinum toxin A; muscarinic receptor blocking agent; adult; aged; Article; bladder capacity; disease severity; drug efficacy; female; follow up; gender; human; major clinical study; male; micturition; overactive bladder; postvoid residual urine volume; sensitivity and specificity; treatment outcome; treatment response; urinary urgency; urine incontinence; bladder; clinical trial; drug effects; innervation; intravesical drug administration; middle aged; odds ratio; pathophysiology; prospective study; sex difference; Urinary Bladder, Overactive; Urinary Incontinence; urodynamics; very elderly; Acetylcholine Release Inhibitors; Administration, Intravesical; Aged; Aged, 80 and over; Botulinum Toxins, Type A; Female; Humans; Male; Middle Aged; Muscarinic Antagonists; Odds Ratio; Prospective Studies; Sex Factors; Treatment Outcome; Urinary Bladder; Urinary Bladder, Overactive; Urinary Incontinence; Urination; Urodynamics |
顯示於: | 醫學系 |
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