Videourodynamic changes of botulinum toxin A in patients with neurogenic bladder dysfunction (NBD) and idiopathic detrusor overactivity (IDO) refractory to drug treatment
| Autor: | A. Al-Kaabneh, J. Seibold, C. Lang, Christian Schwentner, Saladin Alloussi, S.H. Alloussi, R. Eichel |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Time Factors Urology Drug Resistance Video Recording urologic and male genital diseases Injections Botulinum toxin a Drug treatment Refractory Internal medicine Humans Medicine Botulinumtoxin a In patient Longitudinal Studies Botulinum Toxins Type A Urinary Bladder Neurogenic Neurogenic bladder dysfunction Aged Retrospective Studies Aged 80 and over Urinary Bladder Overactive business.industry Urinary Incontinence Urge Middle Aged medicine.disease female genital diseases and pregnancy complications Urodynamics Safety profile Treatment Outcome Urinary Incontinence Female business Follow-Up Studies |
| Zdroj: | World Journal of Urology. 30:367-373 |
| ISSN: | 1433-8726 0724-4983 |
| Popis: | To document the videourodynamic changes and the efficacy and safety profile of botulinum toxin A (BoNT-A, Dysport(®)) in neurogenic bladder dysfunction (NBD) including neurogenic detrusor overactivity, low-compliance and break-low-compliance and idiopathic detrusor overactivity (IDO), in patients refractory to drug treatment.Sixty-four patients with NBD and 170 patients with IDO were treated between 2002 and 2007. Diagnostic approach included medical history, bladder diary, standardised questionnaire rating quality of life, sonography, videourodynamic and temporary sacral nerve block. All patients received BoNT-A-injection under local anaesthesia. Patients with NBD received 500 mouse units (MU) and patients with IDO received 250 MU BoNT-A, injected into ten sites including the trigonum. Patients were followed up 6 weeks after injection.For NBD, 58/64 (91%) patients achieved satisfactory continence during the day as well as significant reduction in incontinence episodes and improvement in quality of life. For IDO, 158/170 (93%) were responders with regard to urgency and urge incontinence. Urodynamical changes included significant improvement in the following parameters in both groups: increase in maximum cystometric capacity and decrease in detrusor pressure. BoNT-A was well tolerated; no drug-related side effects were documented. No de novo vesicoureteral reflux was induced. Long-term follow-up revealed a mean duration effect of BoNT-A of 5.7 months in NBD and 4.9 months in IDO.BoNT-A is highly effective in NBD as well as in IDO suggesting that this is a good treatment option for patients with detrusor overactivity. Furthermore, intratrigonal injection is safe and not associated with vesicoureteral reflux. |
| Databáze: | OpenAIRE |
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