[29] Time of onset of symptom relief after intraoperative detrusor injection of botulinum toxin A in patients with neurogenic and non-neurogenic overactive bladder syndrome
Objective: To investigate the controversy that still exists regarding the time of onset of symptom relief after intraoperative detrusor injection of botulinum toxin A (BOTOX) in patients with neurogenic and non-neurogenic overactive bladder syndrome (OAB), as intra-detrusor injection of botulinum to...
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| Autores principales: | , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Taylor & Francis Group
2018
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/d9a3dcb3d3cc46359b7a23e71100cf02 |
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| Sumario: | Objective: To investigate the controversy that still exists regarding the time of onset of symptom relief after intraoperative detrusor injection of botulinum toxin A (BOTOX) in patients with neurogenic and non-neurogenic overactive bladder syndrome (OAB), as intra-detrusor injection of botulinum toxin has emerged as a second-line option for patients with neurogenic and non-neurogenic OAB who are refractory to first-line treatment modalities. Methods: This is a retrospective study of 71 patients, who underwent intra-detrusor injection of botulinum toxin A from December 2012 to December 2017. All procedures were performed in a single institute by the same surgeon. Data analysed included patient demographics, disease specifics, and outcomes of the procedure. Results: The mean (range) age of the 71 patients was 44 (14–75) years, 48 of which were females (68%). In all, 58% of the patients had neurogenic bladder and 42% had non-neurogenic bladder. Metabolic syndrome was identified in 36 patients (50%) and 24 (34%) had neurological deficits. The neurogenic bladder group received 200 U of BOTOX, whereas the rest received 100 U. The median response time to BOTOX injection was 7 days and this was used as a threshold: Group 1 was early response (⩽7 days) and Group 2 late response (>7 days). This was utilised to analyse the effect of certain variables on response time. Age, gender, smoking status and underlying pathology had no significant effect on response time with P values of 0.14, 0.95, 0.71 and 0.7, respectively. Only diabetes and type of incontinence (wet vs dry) played a significant role with regards to response time with P values of 0.004 and 0.009, respectively. Conclusion: The median time of onset after intradetrusor BOTOX injection was found to be 7 days. Only diabetes and type of incontinence significantly affected the response time to BOTOX injection. A larger sample size and a prospective analysis of data are warranted to verify and validate these findings. |
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