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[The effect of botulinum toxin injection into the bladder for overactive bladder: two case]
Takeshi Watanabe1, Motoaki Saito, Shinji Hirakawa
1Department of Urology, Faculty of Medicine, Tottori University, Yonago, Japan.
Summary
Intradetrusor botulinum-A toxin (BTX-A) effectively treats overactive bladder, reducing incontinence. Dosage adjustments are crucial, as one case required self-catheterization due to urinary retention.
Area of Science:
- Urology
- Neurology
Background:
- Overactive bladder (OAB) significantly impacts quality of life, often proving refractory to standard anticholinergic therapies.
- Intractable OAB necessitates exploring advanced treatment modalities for improved patient outcomes.
Observation:
- Two cases of severe, intractable overactive bladder were treated with intradetrusor injections of botulinum-A toxin (BTX-A).
- Procedures involved cystoscopic guidance and targeted BTX-A delivery into the detrusor muscle, with anesthesia.
Findings:
- Case 1: Complete resolution of urge urinary incontinence was achieved in a patient with neurogenic detrusor overactivity.
- Case 2: While urge incontinence decreased, the patient developed urinary retention requiring intermittent self-catheterization, highlighting potential side effects.
- BTX-A demonstrated a significant increase in bladder capacity and reduction in incontinence frequency.
Implications:
- Intradetrusor BTX-A offers a promising therapeutic option for refractory overactive bladder.
- Individualized dosing strategies for BTX-A are essential to balance efficacy and minimize adverse events like urinary retention.
- Further research into optimal BTX-A dosage and patient selection is warranted.