Botulinum Toxin A Improves the Quality of Life of Patients with Neurogenic Urinary Incontinence

Schurch, Brigitte; Denys, Pierre; Kozma, Chris M; Reese, Pat Ray; Slaton, Terra; Barron, Richard

doi:10.1016/j.eururo.2007.04.026

Cited by 94 publications

(36 citation statements)

References 21 publications

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“…1 Currently, most SCI patients with DSD are treated with detrusor BoNT-A injections followed by CIC to restore urinary continence and achieve better QoL. [19][20][21] Although patients treated with 200 U of Botox might still have mild urinary incontinence, some patients preferred retaining spontaneous voiding and were satisfied with this treatment outcome. 18 It is important to realize the desire and willingness of patients with SCI to deal with low urinary tract dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Kuo

2011

Spinal Cord

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Study design: The study was designed as a single-arm clinical trial. Objectives: To investigate the therapeutic effects of detrusor botulinum toxin A (BoNT-A) treatment in patients with different levels of spinal cord injury (SCI) and types of detrusor sphincter dyssynergia (DSD). Setting: Patients with chronic suprasacral SCI and neurogenic detrusor overactivity (NDO) were treated with 200-U BoNT-A detrusor injection in a tertiary university hospital in Taiwan. Methods: Outcome assessment of urodynamic parameters and therapeutic satisfaction were performed at 3 and 6 months among patients with different demographics, SCI levels and types of DSD. The treatment outcomes were assessed by changes in Urogenital Distress Inventory 6-item short form (UDI-6), quality of life (QoL) index and detrusor pressure at maximum flow rate (Pdet.Qmax). Results: A total of 38 patients with a mean age of 40.1±12.4 years and median duration of SCI of 10.3 years were enrolled. Satisfactory response was reported in 23 (60%) patients. Significant improvements in the UDI-6 and QoL were reported and significant increases of cystometric bladder capacity and post-void residual were noted in overall patients after treatment. Patients with different clinical demographics and urodynamic parameters had similar treatment outcomes and UDI-6 scores. In 11 patients receiving repeat injections of 300 U of BoNT-A after failure of a previous 200 U injection, the treatment outcomes were not significantly different, except that the PdetQmax at 6 months were higher in the group that received 200 U of BoNT-A. Conclusion: Patients with different SCI levels or DSD types had similar treatment outcomes after detrusor 200 U BoNT-A injections for NDO.

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Section: Discussionmentioning

confidence: 99%

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Kuo

2011

Spinal Cord

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“…Its safety and efficacy have been confirmed in a randomized placebo-controlled study (7). Several studies have evaluated the use of botulinum toxin type A injections into the detrusor muscle of spinal cord injury patients in an attempt to reduce neurogenic detrusor overactivity, increase bladder capacity, and reduce urge incontinence (6,8). In our practice, we have observed differing clinical responses following the use of this drug, despite the improvements in most urodynamic parameters.…”

Section: Introductionmentioning

confidence: 85%

Botulinum toxin A in the treatment of spinal cord injury patients with refractory neurogenic detrusor overactivity

Alvares¹,

Silva²,

Barboza³

et al. 2010

Int. braz j urol.

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Purpose: To evaluate the efficacy of botulinum toxin type A injections in the detrusor muscle in patients with spinal cord injury and urinary incontinence due to detrusor overactivity and refractory to anticholinergic agents. Materials and Methods: We prospectively evaluated 22 patients with spinal cord injuries, whose bladders were emptied by intermittent catheterization. All patients had detrusor overactivity and urinary incontinence that proved difficult to treat, despite using high doses of two different anticholinergics. The pre-treatment assessment included a complete urodynamic study and ultrasonography of the kidneys and urinary tract. A one-month follow-up was completed with urodynamic evaluation and the clinical response was evaluated through outpatient consultations and telephone contact. Results: After the procedure, the maximum cystometric capacity and the bladder reflex volume increased, whereas the maximum detrusor pressure and compliance decreased. The mean duration of continence was 7 ± 7 months. In 18 patients (81.8%), it was necessary to administer anticholinergics to achieve continence. Five patients (22.7%) had indication of reinjection, and augmentation cystoplasty was indicated in 9 patients (40.9%). Conclusion:The use of botulinum toxin in the treatment of neurogenic detrusor overactivity refractory to anticholinergics is an option before more invasive treatments, such as augmentation cystoplasty, are attempted. In our study as well as in the literature, there was improvement in most urodynamic parameters. Overall, 40.9% of patients underwent augmentation cystoplasty and 81.8% of patients needed anticholinergic agents to reach urinary continence. Further studies are necessary to improve the procedure and to achieve better clinical results.

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“…Schurch et al reported a study in which quality of life, as measured by I-QOL, was the primary outcome measure and was significantly improved in comparison with placebo for up to 6 months post-injection with doses of either 200 U or 300 U. 41 Health-related quality of life data have also been reported for the two main trials mentioned above. 42,43 In these studies, health-related quality of life measures included the total I-QOL score 42 and three domain scores (avoidance and limiting behavior, psychosocial, and social embarrassment), the modified Overactive Bladder Patient Satisfaction with Treatment Questionnaire (OAB-PSTQ), and Patient Global Assessment.…”

Section: Quality Of Lifementioning

confidence: 99%

Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA

Ethans¹,

Casey²,

Bard³

et al. 2014

DNND

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People with neurogenic overactive bladder from either multiple sclerosis or spinal cord injury often suffer significant morbidity and decreased quality of life. Here we review the pathophysiology of neurogenic overactive bladder and the impact it can have on people with multiple sclerosis or spinal cord injury. We also address the various traditional treatment options and focus on the use of botulinum toxin A (specifically onabotulinumtoxinA) for this condition.

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Botulinum Toxin A Improves the Quality of Life of Patients with Neurogenic Urinary Incontinence

Cited by 94 publications

References 21 publications

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Botulinum toxin A in the treatment of spinal cord injury patients with refractory neurogenic detrusor overactivity

Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA

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