The Effects of Botulinum Toxin A Injections on Patients with Radiogenic Lower Urinary Tract Symptoms

Botulinum toxin A (BTX-A) injection into the detrusor vesicae is an established therapy for neurogenic lower urinary tract dysfunction as well as idiopathic overactive bladder. Pelvic radiotherapy causes comparable lower urinary tract symptoms (LUTS) in a third of radiated patients. Little is known about the effects of BTX-A injections into the detrusor vesicae in the management of radiogenic LUTS. Our aim was to assess the effect of BTX A injections on these symptoms and related quality of life. Material and Methods: In total, 28 patients with BTX-A injections for radiogenic LUTS were assessed retrospectively. We analyzed symptoms recorded in bladder diaries, the results of quality-of-life questionnaires (ICIQ-LUTSqol), and urodynamic studies (UDS) before and after BTX-A injections. Results: A significant reduction in daily micturition frequency, nocturia, and pad consumption was demonstrated in the overall cohort and in gender-related subgroup analysis. There was a significant decrease in the ICIQ-LUTSqol independent of gender or BTX-A units. For UDS maximum cystometric bladder capacity (188.0 vs. 258.2 mL, p = 0.043), micturition volume (138.2 vs. 216.7 mL, p = 0.018), and first desire to void (98.2 vs. 171.2 mL, p = 0.042) was significantly improved. No side effects of the toxin injection or urinary retention were observed. Conclusions: Intradetrusor injection therapy with BTX-A could represent a safe and effective therapeutic option for radiogenic LUTS with increasing quality of life, reductions in symptoms, and the improvement of urodynamic parameters.