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

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

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background To evaluate the efficacy of intradetrusor botulinum toxin-A (BTX-A) in idiopathic overactive bladder patients (OAB) refractory to antimuscarinic 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.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalInternational Urology and Nephrology
Volume44
Issue number1
DOIs
StatePublished - Feb 1 2012

Keywords

  • Botulinum toxin-A
  • Detrusor overactivity
  • Incontinence
  • Overactive bladder
  • Urodynamics

ASJC Scopus subject areas

  • Nephrology
  • Urology

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