Monzón FJF, Batista MJE, Bassas PA

Language: Spanish
References: 8
Page: 1-9
PDF size: 274.95 Kb.

ABSTRACT

Background: according to EUA and AUA guidelines, intradetrusor botulinum toxin A (TxBA) is a first-line alternative in cases of therapeutic failure, contraindications, intolerance to medication due to adverse effects, or refusal of conservative treatment for overactive bladder (OAB).
Objective: to assess the impact on visit frequency and the clinical and urodynamic characteristics of patients over 18 years of age undergoing intradetrusor botulinum toxin application in a functional urology service in Barcelona, Spain.
Patients and methods: descriptive, retrospective, observational study analyzing the medical records of patients undergoing botulinum toxin application, with a 2-year follow-up. Medical records were reviewed, and follow-up calls were made to all patients. Prior informed consent were signed, the medical records were reviewed, and follow-up calls were made to all patients. Descriptive and inferential statistics were used, statistical significance p value ‹ 0.05.
Results: total of 23 non-neurogenic patients were studied, 62.5 % (15) women and 34.8 % (8) men, with a mean age of 63.52 ± 3.3 years. Prior to the application of TxBA, 78.3 % (18) had received anticholinergic treatment, and 47.8 % (11) had been treated with Mirabegron. The mean number of medical visits per year before TxBA was 4.0. Pre-TxBA evaluations showed a mean bladder capacity of 110.2 ± 25 ml, a daytime voiding frequency of 1.7 hours, and 2.86 nocturnal episodes per night. After a mean follow-up period of 12.21 months post-TxBA application, medical visits were reduced to 2.24 visits per year (p = 0.001). Symptomatic assessment revealed an increase in mean daytime voiding frequency to 2.8 ± 0.7 hours, accompanied by a decrease in nocturnal episodes to 1.9 ± 0.8 per night, both showing statistically significant reductions (p=0.001)
Conclusion: the application of intradetrusor botulinum toxin leads to a reduction in visit frequency in patients with overactive bladder. It is a safe procedure with few complications and symptom improvement.

REFERENCES

1. Hung FC, Kuo HC. Liposome-EncapsulatedBotulinum Toxin A in Treatment of FunctionalBladder Disorders. Toxins. 2022;14(12): 838.https://doi.org/10.3390/toxins14120838.

2. Derisavifard S, Giusto LL, Zahner P, RuebJJ, Goldman HB. Safety of IntradetrusorOnabotulinumtoxinA (BTX-A) Injection in theAsymptomatic Patient With a Positive UrineDip. Urology. 2020;135: 38–43. https://doi.org/10.1016/j.urology.2019.09.030.

3. Errando-Smet C, Larrea G, Cidre J, LovemanC, Khalaf K, Aracil J, et al. A cost-effectivenessAnalysis Of Onabotulinumtoxina For OveractiveBladder In Patients Who Are InadequaTEL YManaged With Anticholinergic MedicationsIn Spain. In: Neurourology And Urodynamics.Wiley-Blackwell 111 River St, Hoboken 07030-5774, NJ USA; 2014. p. 771–772.

4. Jiang YH, Liao CH, Kuo HC. Current and potentialurological applications of botulinum toxin A.Nature Reviews. Urology. 2015;12(9): 519–533.https://doi.org/10.1038/nrurol.2015. 93.

5. Drake MJ, Nitti VW, Ginsberg DA,Brucker BM, Hepp Z, McCool R, et al.Comparative assessment of the efficacy ofonabotulinumtoxinA and oral therapies(anticholinergics and mirabegron) for overactivebladder: a systematic review and network metaanalysis.BJU international. 2017;120(5): 611–

6. https://doi.org/10.1111/bju.13945.6. Murray B, Miles-Thomas J, Park AJ, NguyenVB, Tung A, Gillard P, et al. Cost-effectivenessof overactive bladder treatments from a UScommercial and payer perspective. Journal ofComparative Effectiveness Research. 2023;12(2):e220089. https://doi.org/10.2217/cer-2022-0089.

7. Del Popolo G, Gemma L. Intradetrusorbotulinum toxin as the first-line treatmentfor neurogenic detrusor overactivity: Cons.Progres En Urologie: Journal De l’AssociationFrancaise D’urologie Et De La Societe FrancaiseD’urologie. 2023;33(4): 176–177. https://doi.org/10.1016/j.purol.2022.12.008.

8. da Silva CM, Chancellor MB, Smith CP, CruzF. Use of botulinum toxin for genitourinaryconditions: What is the evidence? Toxicon:Official Journal of the International Society onToxinology. 2015;107(Pt A): 141–147. https://doi.org/10.1016/j.toxicon.2015.07.333.