Low dose intradetrusor injections of onabotulinumtoxinA in women with overactive bladder symptoms or the painful bladder syndrome: unfavorable balance between clinical efficacy and the need for catheterization
| Autor: | Jan Groen, Wouter J.C. Marchand, Bertil F.M. Blok, Gert R. Dohle |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Urogynaecologia International Journal, Vol 26, Iss 1 (2012) |
| Druh dokumentu: | article |
| ISSN: | 1121-3086 2038-8314 |
| DOI: | 10.4081/uij.2012.e10 |
| Popis: | We evaluated our results with low dose intradetrusor injections of onabotulinu - mtoxinA in women with overactive bladder symptoms and the painful bladder syndrome in terms of clinically successful outcomes and the need for clean intermittent self-catheterization (CISC) and in relation to urodynamic aspects. The files of patients treated with 100 U of onabotulinumtoxinA injected at 20 sites with sparing of the trigone were retrospectively analyzed. Nearly all patients completed voiding- incontinence diaries and the King’s Health Questionnaire (KHQ) pre- and post-operatively. Cystometric and pressure-flow studies were done in the majority of patients. Success was defined as the patient’s and clinician’s joint choice for re-treatment with the same dose of onabotulinumtoxinA after a period of at least six months of clinical satisfaction. Twenty-six women were treated. On average, the improvement in most voiding diary parameters and in most KHQ categories lasted less than six and three months, respectively. Eight patients (31%) were scheduled for re-treatment with 100 U again after at least six months. No prognostic cystometric parameters were found. Six patients (23%) needed CISC. None of the bladder contraction strength parameters derived from the pressure-flow studies appeared predictive of the need of CISC. We obtained a success rate of 31% after six months with 100 U of onabotulinumtoxinA, while 23% of the patients applied CISC. We consider this success rate low and find the balance between the success rate and the rate of patients needing CISC inadequate. |
| Databáze: | Directory of Open Access Journals |
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