Use of onabotulinum toxin A in patients with idiopathic overactive bladder and a lack of efficacy, intolerance or contraindication with anticholinergics

• Published in: Urologia Colombiana 2018-03, Vol.27 (1), p.086-091
• Main Authors: Ospina-Galeano, Irma Amparo, Medina-Polo, José, de la Rosa-Kerhmann, Susana, Villacampa-Aubá, Felipe, Guerrero-Ramos, Felix, Passas-Martínez, Juan Bautista
• Format: Article
• Language: English
• Subjects: Anticholinergics; Anticolinérgicos; Contracción involuntaria del detrusor; Idiopathic overactive bladder; Incontinencia urinaria; Involuntary detrusor contraction; Onabotulinum toxin A; Onabotulinumtoxina A; Original Article | Artículo Original; Parámetros urodinámicos; Urinary incontinence; Urodynamic parameters; Vejiga hiperactiva idiopática
• ISSN: 0120-789X; 2027-0119
• DOI: 10.1016/j.uroco.2015.10.010

To assess the efficacy and safety of onabotulinum toxin A in patients with idiopathic overactive bladder inadequately managed with anticholinergics. A prospective, open-label, single centre, and interventional study was conducted, from 2008 to 2013, on consecutive patients with idiophatic overactive bladder that showed lack of efficacy or intolerance to anticholinergic agents. The study included 73 female patients aged 58.9±12.9 years. A dose of 100 and 200 units of toxin were administered in 89 and 5 cases, respectively. Nineteen patients received a second injection, 8 patients received 3, and one patient was treated 4 times. Clinically, it was observed that 98% patients had urge urinary incontinence at baseline, as compared with 42% under treatment. Similar results were obtained regarding the number of pads used per day, from 2.8 at baseline to 0.5 after treatment as regards the urodynamic parameters, the first desire to void volume improved from 97±63ml to 139±81ml. Similar results were obtained as regards cystometric capacity and the volume of the first involuntary detrusor contraction. One patient had a positive urine culture resolved using a conventional oral antibiotic regimen. Intermittent catheterisation was required in 5 patients during the first week. Onabotulinum toxin A injections significantly improved, not only the clinical symptoms, but also the urodynamic parameters in patients with idiopathic overactive bladder inadequately managed with anticholinergic drugs. This is a simple technique with minimal adverse effects and generally well tolerated. Evaluar la eficacia y seguridad de onabotulinumtoxina A en pacientes con vejiga hiperactiva idiopática con falta de eficacia, intolerancia o contraindicación para el uso de anticolinérgicos. Se realizó un estudio observacional, prospectivo, abierto en un único centro entre 2008 y 2013, en pacientes consecutivos con vejiga hiperactiva idiopática con falta de eficacia o intolerancia a los anticolinérgicos. Las 73 pacientes fueron mujeres con edad de 58,9±12,9 años. Se administraron 100 y 200 unidades de toxina en 89 y 5 casos, respectivamente. Diecinueve pacientes recibieron una segunda inyección, 8 pacientes 3 inyecciones y un paciente 4. Clínicamente se observó que inicialmente un 98% de las pacientes tenían incontinencia urinaria de urgencia y después del tratamiento solo un 42%; el número de absorbentes por día, pasó de 2,8 al inicio a 0,5 después del tratamiento. Respecto a los parámetros urodiná