Botulinum Toxin Type A Injection After Failure of Augmentation Enterocystoplasty Performed for Neurogenic Detrusor Overactivity: Preliminary Results of a Salvage Strategy. The ENTEROTOX Study
| Autor: | Brigitte Perrouin-Verbe, Loïc Le Normand, Marianne de Sèze, Xavier Gamé, Benjamin Bernuz, Alexia Even, Alain Ruffion, Romain Boissier, Brigitte Schurch, Gilles Karsenty, Carine Ciceron, F. Michel, Hubert Tournebise, Philippe Grise, Pierre Denys, Emmanuel Chartier-Kastler, Andrea Manunta, Véronique Forin, Christian Saussine, Sarah Gaillet |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent Side effect Urology Urinary Bladder 030232 urology & nephrology Enlarged bladder Injections Botulinum toxin a Young Adult 03 medical and health sciences 0302 clinical medicine Humans Medicine In patient Treatment Failure Clinical efficacy Botulinum Toxins Type A Urinary Bladder Neurogenic Retrospective Studies Salvage Therapy Respiratory distress Urinary Bladder Overactive business.industry Retrospective cohort study Neuromuscular Agents 030220 oncology & carcinogenesis Anesthesia Urologic Surgical Procedures Detrusor pressure Female business |
| Zdroj: | Urology. 129:43-47 |
| ISSN: | 0090-4295 |
| Popis: | Objective To evaluate the clinical efficacy, urodynamic effect and safety of Botulinum Toxin A (BTXA) injections after failure of augmentation enterocystoplasty (AE) performed for neurogenic detrusor overactivity. Patients and Methods We performed a multicenter retrospective study that included patients who had AE and at least one injection of BTXA after AE in 15 GENULF (French Speaking Neuro-Urology Study Group) centers. Clinical and urodynamic data were collected from medical files according to a standardized questionnaire and colligated in an anonymous database. Results Thirty-three patients with an injection of BTXA after AC in 9 out of 15 centers were included. Mean age at the time of AE was 24 ± 15 years. Overall efficacy (defined by clinical efficacy associated with a request by the patient for reinjection) was observed in 58% of the patients. Mean maximum cystomanometric capacity increased by 28% (333 ± 145 vs 426 ± 131 mL; P = .007) and maximum detrusor pressure (Pdet max) decreased by 43% (44 ± 37 vs 25 ± 18 cm H2O; P = .02) after BTXA. Only one side effect was recorded out of the 152 procedures (transient generalized muscle weakness without respiratory distress). Conclusion In patients with failure after AE performed for neurogenic detrusor overactivity, injection of BTXA in the enlarged bladder was effective in over half of the cases with low morbidity. If this therapeutic approach were confirmed, it could be proposed as an alternative to AE surgical revision. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect