Botulinum Toxin in Neurogenic Detrusor Overactivity
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Purpose: To evaluate the effects of botulinum toxin on urodynamic parameters and quality of life in patients with neurogenic detrusor overactivity. Methods: Thirty four adult patients with spinal cord injury and detrusor overactivity were selected. The patients received 300 units of botulinum toxin type A. The endpoints evaluated with the episodes of urinary incontinence and measured the maximum cystometric capacity, maximum amplitude of detrusor pressure and bladder compliance at the beginning and end of the study (24 weeks) and evaluated the quality of life by applying the Qualiveen questionnaire. Results: A significant decrease in the episodes of urinary incontinence was observed. All urodynamic parameters presented a significant improvement. The same was observed in the quality of life index and the specific impact of urinary problems scores from the Qualiveen questionnaire. Six patients did not complete the study, two due to incomplete follow-up, and four violated protocol and were excluded from the analyses. No systemic adverse events of botulinum toxin type A were reported. Conclusions: A botulinum toxin type A showed a significantly improved response in urodynamics parameters and specific and general quality of life.
Abstract
Purpose: To evaluate the effects of botulinum toxin on urodynamic parameters and quality of life in patients with neurogenic detrusor overactivity. Methods: Thirty four adult patients with spinal cord injury and detrusor overactivity were selected. The patients received 300 units of botulinum toxin type A. The endpoints evaluated with the episodes of urinary incontinence and measured the maximum cystometric capacity, maximum amplitude of detrusor pressure and bladder compliance at the beginning and end of the study (24 weeks) and evaluated the quality of life by applying the Qualiveen questionnaire. Results: A significant decrease in the episodes of urinary incontinence was observed. All urodynamic parameters presented a significant improvement. The same was observed in the quality of life index and the specific impact of urinary problems scores from the Qualiveen questionnaire. Six patients did not complete the study, two due to incomplete follow-up, and four violated protocol and were excluded from the analyses. No systemic adverse events of botulinum toxin type A were reported. Conclusions: A botulinum toxin type A showed a significantly improved response in urodynamics parameters and specific and general quality of life.
참고문헌 (26)
- Pannek J, "Does optimizing bladder management equal optimizing quality of life? Correlation between health-related quality of life and urodynamic parameters in patients with spinal cord lesions", Urology, 74, pp.263~266 (2009)
- Grise P, "Efficacy and tolerability of botulinum toxin type A in patients with neurogenic detrusor overactivity and without concomitant anticholinergic therapy: comparison of two doses", Eur Urol, 58, pp.759~766 (2010)
- West DA, "Role of chronic catheterization in the development of bladder cancer in patients with spinal cord injury", Urology, 53, pp.292~297 (1999)
- Lapides J, "Clean, intermittent self-catheterization in the treatment of urinary tract disease", J Urol, 107, pp.458~461 (1972)
- Feifer A, "Contemporary role of suprapubic cystostomy in treatment of neuropathic bladder dysfunction in spinal cord in jured patients", Neurourol Urodyn, 27, pp.475~479 (2008)
- Karsenty G, "Botulinum toxin A (Botox) intradetrusor injections in adults with neurogenic detrusor overactivity", neurogenic overactive bladder: a systematic literature review, 2008, pp.53, 275~287
- Lee YS, "Symptom change after discontinuation of successful antimuscarinic treatment in patients with overactive bladder symptoms: a randomised, multicentre trial", Int J Clin Pract, 65, pp.997~1004 (2011)
- Kay GG, "Antimuscarinic agents: implications and concerns in the management of overactive bladder in the elderly", Clin Ther, 27, pp.127~138 (2005)
- Chapple CR, "Muscarinic receptor antagonists in the treatment of overactive bladder", Urology, 55(5A Suppl), pp.33~46 (2000)
- Di Stasi SM, "Intravesical electromotive administration of oxybutynin in patients with detrusor hyperreflexia unresponsive to standard anticholinergic regimens", J Urol, 165, pp.491~498 (2001)
- Abdel-Meguid TA, "Botulinum toxin-A injections into neurogenic overactive bladder--to include or exclude the trigone? A prospective, randomized, controlled trial", J Urol, 184, pp.2423~2428 (2010)
- Schurch B, "Botulinum toxin type a is a safe and effective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study", J Urol, 174, pp.196~200 (2005)
- Apostolidis A, "Understanding the Role of Botulinum Toxin A in the Treatment of the Overactive Bladder—More than Just Muscle Relaxation", Eur Urol Suppl, 5, pp.670~678 (2006)
- Schurch B, "Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results", J Urol, 164(3), pp.692~697 (2000)
- Wu JM, "Cost-effectiveness of botulinum toxin a versus anticholinergic medications for idiopathic urge incontinence", J Urol, 181, pp.2181~2186 (2009)
- Wefer B, "Treatment outcomes and resource use of patients with neurogenic detrusor overactivity receiving botulinum toxin A (BOTOX) therapy in Germany", World J Urol, 28, pp.385~390 (2010)
- Maynard FM Jr, "International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association", Spinal Cord, 35, pp.266~274 (1997)
- Pannek J, "Long-term effects of repeated intradetrusor botulinum neurotoxin A injections on detrusor function in patients with neurogenic bladder dysfunction", BJU Int, 104, pp.1246~1250 (2009)
- D’Ancona CA, "Quality of life of neurogenic patients: translation and validation of the Portuguese version of Qualiveen", Int Urol Nephrol, 41, pp.29~33 (2009)
- Schafer W, "Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies", Neurourol Urodyn, 21, pp.261~274 (2002)
- Abrams P, "The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society", Urology, 61, pp.37~49 (2003)
- Reitz A, "European experience of 200 cases treated with botulinum-A toxin injections into the detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity", Eur Urol, 45, pp.510~515 (2004)
- Giannantoni A, "Six-year follow-up of botulinum toxin A intradetrusorial injections in patients with refractory neurogenic detrusor overactivity: clinical and urodynamic results", Eur Urol, 55, pp.705~711 (2009)
- Karsenty G, "Persistence of therapeutic effect after repeated injections of botulinum toxin type A to treat incontinence due to neurogenic detrusor overactivity", Urology, 68, pp.1193~1197 (2006)
- Schurch B, "Botulinum toxin A improves the quality of life of patients with neurogenic urinary incontinence", Eur Urol, 52, pp.850~858 (2007)
- Compérat E, "Histologic features in the urinary bladder wall affected from neurogenic overactivity: a comparison of inflammation, oedema and fibrosis with and without injection of botulinum toxin type A", Eur Urol, 50, pp.1058~1064 (2006)