Experience with Injections of Botulinum Toxin Type A into the Detrusor Muscle

Miyagawa, Ikuo; Watanabe, Tetsuo; Isoyama, Tadahiro; Honda, Masashi; Kobayasi, N.; Hikita, Kat suya; Saito, M.; Hirakawa, Shinji

doi:10.1055/s-0029-1224660

Cited by 4 publications

(8 citation statements)

References 4 publications

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“…DO was eliminated in eight (50%) of 16 patients 4 weeks after injection, which is compatible with known rates ranging from 33% to 74% 8,9 . Increase of cystometric capacity was also shown as other reports have pointed out 7–14,18–20 …”

Section: Discussionsupporting

confidence: 87%

“…[6][7][8][9][10][11][12] Although the use of BTX-A has not yet been approved for urinary tracts in Japan, Watanabe et al reported the initial experience with intradetrusor BTX-A injection for Japanese patients with OAB. 13,14 In the present report, we describe the short-term efficacy of BTX-A for Japanese individuals with non-neurogenic OAB.…”

Section: Introductionmentioning

confidence: 92%

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Botulinum toxin A submucosal injection for refractory non‐neurogenic overactive bladder: Early outcomes

et al. 2011

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Abstract:The objective of the present study was to assess the short-term effects of botulinum toxin A (BTX-A) injection for refractory non-neurogenic overactive bladder (OAB) in the setting of a prospective multicenter clinical trial. Refractory OAB was defined as persistent urgency urinary incontinence (UUI) Նonce a week despite taking anticholinergic agents, or the incapability to continue the agents because of the adverse effects. A total of 100 U of BTX-A were reconstituted in 15 mL of normal saline and an aliquot of 0.5 mL was injected at 30 submucosal sites of the bladder wall. Nine men and eight women aged 67 Ϯ 12 years were included. Subjective daytime frequency, urgency and UUI significantly decreased after treatment. On a 3-day frequency-volume chart, the daytime and night-time frequency of UUI significantly decreased from 5.5 and 0.5 pre-injection to 2.0 and 0.3 postinjection, respectively. Daytime urinary incontinence completely disappeared in six subjects. A urodynamic study showed the disappearance of detrusor overactivity in eight patients and a decrease in five patients. Maximum bladder capacity significantly increased from 179.9 to 267.3 mL. Difficulty on micturition or feeling of incomplete emptying was reported by 23.5% and 43.8% of patients at weeks 2 and 4, respectively. Postvoid residual urine increased to >100 mL in seven patients and >200 mL in one patient after injection; however, none of the patients required clean intermittent catheterization. These findings suggest promising efficacy of BTX-A in Japanese OAB patients.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 92%

Botulinum toxin A submucosal injection for refractory non‐neurogenic overactive bladder: Early outcomes

et al. 2011

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“…There are four articles reporting the efficacy of the BoNT‐A bladder wall injection in Japanese patients with DO so far . Hikita et al .…”

Section: Discussionmentioning

confidence: 99%

“…There are four articles reporting the efficacy of the BoNT-A bladder wall injection in Japanese patients with DO so far. [14][15][16][17] Hikita et al reported the efficacy of 300 units BoNT-A detrusor injection on NDO in 11 patients with SCI, spinal bifida or multiple sclerosis. 16 A significant improvement was shown in UI episodes, quality of life, the bladder capacity and compliance in cystometry.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin A injection for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury: Multi‐institutional experience in Japan

et al. 2014

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Abbreviations & AcronymsObjectives: 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. Methods: 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. Results: 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 (P = 0.004), and the maximum cystometric capacity increased from 100 mL to 296 mL (P = 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. Conclusions:The present findings show the efficacy and tolerability of onabotulinumtoxinA injection for the treatment of neurogenic detrusor overactivity in Japanese spinal cord injury patients.

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“…18,19 In Japan, BoNTA has not been approved for OAB, and the use of BoNTA has been reported in only one small sample-sized open-label study and in some case reports. 20,21 Thus, in the present phase III, randomized, double-blind, placebo-controlled trial, we evaluated the efficacy and safety of BoNTA 100 U in Japanese OAB and UI patients who were not adequately managed with anticholinergics and/or b 3 -adrenergic receptor agonists.…”

Section: Introductionmentioning

confidence: 99%

OnabotulinumtoxinA (botulinum toxin type A) for the treatment of Japanese patients with overactive bladder and urinary incontinence: Results of single‐dose treatment from a phase III, randomized, double‐blind, placebo‐controlled trial (interim analysis)

et al. 2020

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Objective To evaluate the efficacy and safety of onabotulinumtoxinA (botulinum toxin type A) 100 U in patients with overactive bladder and urinary incontinence. Methods This was a phase III, randomized, double‐blind, placebo‐controlled trial in Japanese patients who were inadequately managed with overactive bladder medications (anticholinergics and/or β3‐adrenergic receptor agonists). Eligible patients were randomized 1:1 to receive a single dose of either onabotulinumtoxinA or placebo into the detrusor muscle (n = 124 each). The primary end‐point was the change in the number of daily urinary incontinence episodes at week 12 from baseline. Secondary end‐points included volume voided per micturition, other symptomatic measures (urinary urgency incontinence, micturition, urgency and nocturia) and patient‐reported outcomes. Results In the onabotulinumtoxinA group, there was a significantly greater decrease from baseline in the mean number of daily urinary incontinence episodes compared with the placebo group (2.16; P < 0.001), and significantly greater improvement for all secondary end‐points (P < 0.05). Urinary tract infection, dysuria, urinary retention and post‐void residual urine volume increased represented adverse events occurring at a higher rate in the onabotulinumtoxinA group. The majority of these were mild or moderate in severity. Conclusions Statistically significant and clinically relevant improvements in symptoms and patient‐reported outcomes, and tolerability were seen in patients with overactive bladder and urinary incontinence who had been inadequately managed with overactive bladder medications after using onabotulinumtoxinA.

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Experience with Injections of Botulinum Toxin Type A into the Detrusor Muscle

Cited by 4 publications

References 4 publications

Botulinum toxin A submucosal injection for refractory non‐neurogenic overactive bladder: Early outcomes

Botulinum toxin A submucosal injection for refractory non‐neurogenic overactive bladder: Early outcomes

Botulinum toxin A injection for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury: Multi‐institutional experience in Japan

OnabotulinumtoxinA (botulinum toxin type A) for the treatment of Japanese patients with overactive bladder and urinary incontinence: Results of single‐dose treatment from a phase III, randomized, double‐blind, placebo‐controlled trial (interim analysis)

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