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Role of botulinum toxin-A in refractory idiopathic overactive bladder patients without detrusor overactivity

  • Urology – Original Paper
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Abstract

Background

To evaluate the efficacy of intradetrusor botulinum toxin-A (BTX-A) in idiopathic overactive bladder patients (OAB) refractory to anti-muscarinic therapy, without detrusor overactivity (DOA) on urodynamics.

Methods

Patients with refractory idiopathic OAB without DOA on urodynamics were prospectively enrolled. Subjects completed a 3-day voiding diary (3-VD), urogenital distress inventory-6 questionnaire (UDI-6) and graded their quality of life on a 10-cm visual analog scale (VAS) prior to study enrollment and at week 12 postinjection. All patients underwent multichannel urodynamics at study enrollment and 12 weeks postinjection. Improvement was analyzed based on 3-VD, UDI-6 questionnaire, VAS scores, and urodynamic parameters at week 12 postinjection compared to study enrollment.

Results

The study included 32 patients. Mean ± SD age was 56 ± 16. There were 27 women and 5 men. Nineteen patients had OAB without incontinence (OAB-dry) and 13 patients had OAB with incontinence (OAB-wet). In OAB-dry patients, mean ± SD urinary frequency dropped from 24 ± 11 to 10 ± 4 by week 12. In OAB-wet patients, mean ± SD urge incontinence episodes dropped from 7.9 ± 5 to 0 ± 2.6 by week 12. Mean UDI-6 and VAS scores improved significantly in both groups by week 12 (P = 0.0001). On comparing urodynamic parameters, OAB-wet patients showed significant decrease in maximum detrusor pressure during the voiding phase at week 12 compared to baseline values (P = 0.02).

Conclusions

Refractory idiopathic OAB patients without DOA on urodynamics may benefit from intradetrusor BTX-A.

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Abbreviations

BTX-A:

Botulinum toxin-A.

UDI-6:

Urogenital distress inventory 6.

DOA:

Detrusor overactivity.

OAB-wet:

Overactive bladder with incontinence.

OAB-dry:

Overactive bladder without incontinence.

3-VD:

3-day voiding diary.

VAS:

Visual analog score.

CIC:

Clean intermittent catheterization.

PVR:

Post-void residual.

UUI:

Urge urinary incontinence.

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Acknowledgments

Allergan Inc, USA—Provided funding and Botox vials for the study.

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Authors and Affiliations

  1. Department of Urology, University of Miami-Miller School of Medicine, 1150 NW 14 Street, Suite 309, Miami, FL, 33136, USA

    Prashanth Kanagarajah, Rajinikanth Ayyathurai, Daniel J. Caruso, Christopher Gomez & Angelo E. Gousse

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  1. Prashanth Kanagarajah
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  2. Rajinikanth Ayyathurai
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  3. Daniel J. Caruso
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  4. Christopher Gomez
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  5. Angelo E. Gousse
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Correspondence to Prashanth Kanagarajah.

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Kanagarajah, P., Ayyathurai, R., Caruso, D.J. et al. Role of botulinum toxin-A in refractory idiopathic overactive bladder patients without detrusor overactivity. Int Urol Nephrol 44, 91–97 (2012). https://doi.org/10.1007/s11255-011-9979-9

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  • DOI: https://doi.org/10.1007/s11255-011-9979-9

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