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Botulinum Toxin A Intradetrusor Injection for Treating Neurogenic Detrusor Overactivity, A Single Centre Experience.

Hisham A Mosli1, Mohannad A Awad1, Mamdouh M Rezk1

  • 1Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.

Lower Urinary Tract Symptoms
|December 15, 2015
PubMed
Summary

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Botulinum Toxin A (BoNTA) intradetrusor injections effectively improved bladder function in patients with neurogenic detrusor overactivity. The treatment demonstrated a good clinical response and significant urodynamic improvements with no reported side effects.

Area of Science:

  • Urology
  • Neurology
  • Pharmacology

Background:

  • Neurogenic detrusor overactivity (NDO) is a condition characterized by involuntary bladder contractions.
  • It significantly impacts patients' quality of life, leading to urinary incontinence and other voiding dysfunctions.
  • Current treatments aim to reduce detrusor muscle activity and improve bladder capacity.

Purpose of the Study:

  • To assess the efficacy and safety of Botulinum Toxin A (BoNTA) administered via intradetrusor injections for managing NDO.
  • To evaluate the impact of BoNTA on clinical outcomes and urodynamic parameters in NDO patients.

Main Methods:

  • A cohort of 45 patients with NDO underwent intradetrusor injections of 300 units of BoNTA.
  • The procedure involved 30 equally spaced injections into the bladder wall, excluding the trigone, under cystoscopic guidance.
Keywords:
BoNTAbotulinum toxinintradetrusorneurogenic bladderoveractive bladder

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  • Patients were managed with clean intermittent catheterizations (CICs) post-injection, with follow-up assessments at 6 and 12 weeks.

    • Main Results:

    • A significant clinical response, defined as being dry for over 50% of the time between CICs, was observed in 68.9% at 6 weeks and 66.7% at 12 weeks.
    • Responders showed a 48.2% increase in mean bladder volume and a 33.4% decrease in mean maximum intravesical pressure (to 35.3 cm H2O).
    • No adverse events related to BoNTA or the procedure were reported, and renal function remained stable.

    Conclusions:

    • Intradetrusor BoNTA injections are an effective treatment for neurogenic detrusor overactivity.
    • The treatment leads to significant improvements in both clinical symptoms and urodynamic parameters.
    • BoNTA offers a safe therapeutic option for patients with NDO, with a favorable side effect profile.