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Intradetrusor Injection of Botulinum A Toxin for the Treatment of
Idiopathic Overactive Bladder
Hossam Haroun
Urology Department, Faculty of Medicine -Tanta University, Egypt
Tanta Med. Sc. J 2008; 3(3):134-139
Article type: Original article
Aim: Evaluation of the safety and efficacy of
intradetrusor injection of botulinum A toxin in the treatment of
idiopathic bladder over activity. Patients & Methods: a total of 23
patients with idiopathic overactive bladder received a single dose
of botulinum A toxin (200 u) injected into the detrusor muscle with
flexible needle guided by cystoscope. Subjective changes in the form
of daily frequency, urgency and incontinence episodes were monitored
via a patient diary at 1, 3 and 6 months. Urodynamic assessments in
the form of maximum cystometric capacity and maximum detrusor
pressure during filling at 1, 3 and 6 months follow up were used to
provide objective measures of the treatment effect on bladder
function. Results: There was significant improvement in the
subjective and objective measures. Frequency improved from a mean of
12.6+ 2.1 to 5.9 + 0.942 at one month, 6.8+ 1.23 at three months and
10.2+ 3.02 at six months. Urgency improved from a mean of 9.3+ 2.47
to 4.3 + 0.23 at one month, 4.5+ 0.71 at three months and 6.9+ 2.017
at six months. Incontinence episodes improved from a mean of 3.7+
0.257 to 0.8+ 0.321 at one month, 1.2+ 0.873 at three months and 2.3
+ 0.124 at six months. Maximum cystometric capacity improved from a
mean of 223.8+ 35.26 to 408.2+55.34 at one month, 397.5+85.36 at
three months and 280.4 + 24.39 at six months. Maximum detrusor
pressure improved from 60.7+ 12.87 to 28.7 + 9.37 at one month,
39.5+ 8.34 at three months and 50.6+ 7.36 at six months. Nine
patients (39%) were completely continent at 1 month follow up and
still continent up to 3 months. At 6 months follow up, only 5 of
them continue to be continent. In spite of deterioration observed at
6 months follow up in both subjective and objective parameters, the
changes were still statistically significant (P< 0.05). Conclusion:
Intradetrusor botulinum A toxin injections is safe and effective in
the treatment of idiopathic bladder overactivitry. It provided
beneficial clinical and urodynamic results. Its effect is temporary
and in needs to be repeated after at least 6 months.
ICID 874415
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