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The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA

AIM: The aim was to report the effectiveness and safety OnabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA, USA) intradetrusor injections in spinal cord-injured (SCI) patients with refractory neurogenic detrusor overactivity. And to assess the result based on SCI level. MATERIALS AND METHODS: We...

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Autores principales: Al Taweel, Waleed, Alzyoud, Khalil Mohammed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518367/
https://www.ncbi.nlm.nih.gov/pubmed/26229318
http://dx.doi.org/10.4103/0974-7796.152013
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author Al Taweel, Waleed
Alzyoud, Khalil Mohammed
author_facet Al Taweel, Waleed
Alzyoud, Khalil Mohammed
author_sort Al Taweel, Waleed
collection PubMed
description AIM: The aim was to report the effectiveness and safety OnabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA, USA) intradetrusor injections in spinal cord-injured (SCI) patients with refractory neurogenic detrusor overactivity. And to assess the result based on SCI level. MATERIALS AND METHODS: We reviewed the chart of 103 patients with neurogenic bladder secondary to SCI at the rehab center who received OnabotulinumtoxinA in our Neurourology Department for treatment of lower urinary tract symptoms between January 2007 and December 2013. All patients had a clinical examination, urinalysis, and an urodynamic study at baseline and 3 months after treatment as well as a visual analogue scale (VAS; range scale: 0–10) and a bladder diary checked for 3 days. 300 IU of OnabotulinumtoxinA, detrusor muscle injections were performed in 30 sites under cystoscopic guidance. Outcome measures included frequency of urge urinary incontinence collected by bladder diaries; changes in urodynamic parameters such as maximum cystometric bladder capacity, reflex volume, maximum detrusor pressure; side-effects; antimuscarinic drug consumption and quality of life (QOL) measured with VAS. RESULTS: The study includes 32 female and 71 male with a mean patient age of 29 years (range: 18–56 year). The effect of Botox injection on bladder function was observed within 1–2 week after treatment. The urodynamic parameters were improved significantly after treatment compared with baseline values. There were significant reductions in the frequencies of incontinence episodes after treatment as seen in the voiding diary. A significant improvement in patient satisfaction was found after treatment which was expressed on the VAS assessment, with an improvement of the mean of 3 points. Patients with thoracic and lumbar injury have better result compare to cervical injury patients. The earliest recurrence of clinical symptoms was at 10 weeks. Overall, the mean duration of symptomatic improvement was 8 (2.5–21) months. CONCLUSION: Intradetrusor onabotulinumtoxinA injections are an effective and well-tolerated treatment for neurogenic overactive bladder that will increase patient satisfaction and improve QOL with persisted clinical efficacy for more than 8 months.
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spelling pubmed-45183672015-07-30 The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA Al Taweel, Waleed Alzyoud, Khalil Mohammed Urol Ann Original Article AIM: The aim was to report the effectiveness and safety OnabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA, USA) intradetrusor injections in spinal cord-injured (SCI) patients with refractory neurogenic detrusor overactivity. And to assess the result based on SCI level. MATERIALS AND METHODS: We reviewed the chart of 103 patients with neurogenic bladder secondary to SCI at the rehab center who received OnabotulinumtoxinA in our Neurourology Department for treatment of lower urinary tract symptoms between January 2007 and December 2013. All patients had a clinical examination, urinalysis, and an urodynamic study at baseline and 3 months after treatment as well as a visual analogue scale (VAS; range scale: 0–10) and a bladder diary checked for 3 days. 300 IU of OnabotulinumtoxinA, detrusor muscle injections were performed in 30 sites under cystoscopic guidance. Outcome measures included frequency of urge urinary incontinence collected by bladder diaries; changes in urodynamic parameters such as maximum cystometric bladder capacity, reflex volume, maximum detrusor pressure; side-effects; antimuscarinic drug consumption and quality of life (QOL) measured with VAS. RESULTS: The study includes 32 female and 71 male with a mean patient age of 29 years (range: 18–56 year). The effect of Botox injection on bladder function was observed within 1–2 week after treatment. The urodynamic parameters were improved significantly after treatment compared with baseline values. There were significant reductions in the frequencies of incontinence episodes after treatment as seen in the voiding diary. A significant improvement in patient satisfaction was found after treatment which was expressed on the VAS assessment, with an improvement of the mean of 3 points. Patients with thoracic and lumbar injury have better result compare to cervical injury patients. The earliest recurrence of clinical symptoms was at 10 weeks. Overall, the mean duration of symptomatic improvement was 8 (2.5–21) months. CONCLUSION: Intradetrusor onabotulinumtoxinA injections are an effective and well-tolerated treatment for neurogenic overactive bladder that will increase patient satisfaction and improve QOL with persisted clinical efficacy for more than 8 months. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4518367/ /pubmed/26229318 http://dx.doi.org/10.4103/0974-7796.152013 Text en Copyright: © Urology Annals http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Al Taweel, Waleed
Alzyoud, Khalil Mohammed
The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA
title The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA
title_full The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA
title_fullStr The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA
title_full_unstemmed The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA
title_short The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA
title_sort effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using onabotulinumtoxina
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518367/
https://www.ncbi.nlm.nih.gov/pubmed/26229318
http://dx.doi.org/10.4103/0974-7796.152013
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