Recommandations de bonne pratique clinique pour le suivi des patients neurologiques après injection de toxine botulique intradétrusorienne

Sèze, M. de; Ruffion, A.; Haab, F.; Chartier‐Kastler, Emmanuel; Denys, P.; Gamé, X.; Karsenty, G.; Kerdraon, J.; Perrouin-Verbe, B.; Saussine, C.; Soler, J.-M.; Amarenco, G.

doi:10.1007/s11608-009-0227-z

Cited by 3 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, one may conclude that in the future both investigators and practitioners should expand the studies and practical application of botulinum toxin (23,(49)(50)(51)(52)(53)(54).…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin therapy for nonneurogenic overactive bladder: first experience

Černiauskienė¹,

Jankevičius²

2011

AML

View full text Add to dashboard Cite

The paper presents early experience in the treatment of 20 patients with botulinum toxin injections into the detrusor muscle for the treatment of non-neurogenic overactive bladder (OAB) resistant to anticholinergic drugs.Background. Botulinum toxin, a presynaptic neuromuscular blocking agent, reduces the involuntary bladder contractions that cause urgency, frequency and urge incontinence. We present our early experience with Dysport® injections into the detrusor for the treatment of non-neurogenic overactive bladder (OAB) resistant to anticholinergic drugs.Materials and methods. Using intravenous anaesthesia, 20 patients (18 female and 2 male) with non-neurogenic OAB were injected with botulinum toxin A (Dysport®250 IU diluted in 4 ml normal saline) under cystoscopic visualization in 20 sites in the detrusor muscle, sparing the trigone. The urethral catheter was removed 24 hours after the procedure. Follow-up at 3 and 6 months after the injection included the Urogenital Distress Inventory UDI-6, the Incontinence Impact Questionnaire IIQ-7, clinical parameters and ultrasound measurement of bladder capacity and post-void residual urine volume.Results. All 20 patients completed questionnaires and were examined after 3 and 6 months.At the 3-month follow-up, the median daytime micturation frequency decreased from 10.4 to 4.6 times (p < 0.0001) and at the 6 months follow-up 5 times (p < 0.0001), while nocturia decreased from 4.2 to 1.3 times after 3 months (p < 0.0001) and after 6 months to 2 times (p < 0.0001). Urgency decreased from 6 to 1.5 times after 3 months (p < 0.0001) and to 2 times after 6 months (p < 0.0001), and incontinence decreased from 4.2 times to 1.5 times after 3 months (p < 0.0001) and to 2.1 times after 6 months (p < 0.0001). The median maximum bladder capacity increased from 250 to 420 ml after 3 months (p < 0.0001) and decreased to 350 ml after 6 months (p < 0.0001). The post-void median residual urine volume was 10 ml. Only one patient mentioned a post-operative obstructive voiding difficulty.Eighteen (90%) patients were satisfied with the treatment. In two patients (10%), the amelioration of symptoms lasted for one month only, and later OAB symptoms reappeared.Analysis of the UDI-6 and IIQ-7 questionnaires revealed that botulinum toxin A intradetrusor injection had decreased discomfort for patients and ameliorated their quality of life.Conclusions. Botulinum toxin A injections in the detrusor are effective for the treatment of non-neurogenic OAB. Botulinum toxin A injections are a minimally invasive therapy and offer an alternative treatment for non-neurogenic OAB dysfunction resistant to conservative treatment. The durability of the treatment effect is the objective of the further investigation.

show abstract

“…Therefore, one may conclude that in the future both investigators and practitioners should expand the studies and practical application of botulinum toxin (23,(49)(50)(51)(52)(53)(54).…”

Section: Discussionmentioning

confidence: 99%