Long-term persistence of intradetrusor botulinum toxin in patients with multiple sclerosis

The aim of this study was to assess the persistence of intradetrusor botulinum toxin (BT) injections for the treatment of lower urinary tract dysfunction (LUTD) in patients with multiple sclerosis (MS).

This retrospective single-center study included patients treated with onabotulinumtoxin A injections between May 2005 and March 2024. Both descriptive and analytical analyses were performed. Patients were categorized according to their treatment response, injected dose, and neurological disability score (EDSS) to identify factors associated with treatment response.

A total of 124 patients (82% women; mean age: 54±11.5 years) were included, representing 1,159 injections. The median follow-up was 5 years [1-9]. The median initial EDSS was 5.5 [4-6.5], and the final EDSS was 6.5 [4.5-6.5]. Overall, 82.2% of patients were classified as good responders, and 6.45% as poor responders. Clean intermittent catheterization (CIC) was performed in 49.2% of patients before treatment, initiated in 29%, and never required in 21.8%. No significant differences were found between response groups (p>0.05). Thirty-six patients were lost to follow-up, thirty-three discontinued treatment (including twelve classified as treatment failures), and ten underwent surgery. No major complications were reported.

In this real-life retrospective cohort, intradetrusor botulinum toxin injections were associated with long-term treatment persistence in patients with multiple sclerosis. These results provide complementary data on treatment continuation and response profiles in routine clinical practice.