https://doi.org/10.4081/uij.2012.e10

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

Vol. 26 No. 1 (2012)
Submitted: 31 August 2011
Accepted: 4 October 2012
Published: 5 October 2012
bladder, botulinum toxin type A, detrusor overactivity, onabotulinumtoxinA, overactive bladder, painful bladder syndrome, urinary incontinence.
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Authors

Jan Groen
j.groen.1@erasmusmc.nl
Department of Urology, Erasmus MC, Rotterdam, Netherlands.
Wouter J.C. Marchand
Department of Urology, Heilig Hart Ziekenhuis, Roeselare, Belgium.
Bertil F.M. Blok
Department of Urology, Erasmus MC, Rotterdam, Netherlands.
Gert R. Dohle
Department of Urology, Erasmus MC, Rotterdam, Netherlands.
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.

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How to Cite

Groen, J., Marchand, W. J., Blok, B. F., & Dohle, G. R. (2012). 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. Urogynaecologia, 26(1), e10. https://doi.org/10.4081/uij.2012.e10

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