Is there any Relationship Between Bladder Trabeculation and Efficacy and Safety of Intravesical Botulinum Toxin A Injection in Refractory Idiopathic Overactive Bladder Women?

• Published in: Advanced biomedical research 2017-01, Vol.6 (1), p.113-113
• Main Authors: Zargham, Mahtab, Abedi, Shideh, Alizadeh, Farshid, Khorami, Mohamad, Mohamadi, Mehrdad, Bahrami, Faranak, Sharifiaghdas, Farzaneh, Mazdak, Hamid
• Format: Article
• Language: English
• Subjects: Bladder; Botulinum toxin; botulinum toxin A; Botulinum toxin type A; Dosage; idiopathic; Injection; Original; Patients; Population studies; Quality; Quality of life; Research centers; Statistical analysis; Statistical significance; trabeculation; Trends; Urinary bladder; Urinary tract; Urogenital system; Urology; women; Womens health
• ISSN: 2277-9175; 2277-9175
• DOI: 10.4103/abr.abr_393_14

Background: Intradetrusor injection of botulinum toxin A (BTX-A) might serve as a minimally invasive substitute in patients with refractory idiopathic overactive bladder (RIOAB). The aim of this study was to evaluate the clinical outcomes related to two different doses of abo-BTX-A (AboBTX-A) in patients with RIOAB. Materials and Methods: This prospective clinical trial was performed on 55 women with RIOAB. After determination of trabeculation grade, 300 (no or mild) or 500 (moderate or severe) unit of AboBTX-A (Dysport) was intravesicaly injected. Before 1, 3, and 6 months after intervention, lower urinary tract symptoms during 24 h were recorded. Results: Of the study population, 62% had severe bladder trabeculation. The mean duration of overactive bladder (OAB) was 1.76 versus 5.85 years, for no or mild versus severe trabeculation, respectively. After injections of 300- and 500-unit dosage, there were 19% and 26% early complications such as urinary retention. There was a statistically significant difference between the two groups in OAB score after 1 month (P < 0.001) and duration of OAB symptoms, over three follow-up times (P < 0.001). The mean preinjection OAB scores between patients with and without recurrence were statistically significant (29.36 vs. 25.07; P < 0.03). Urinary tract infection as a late complication was distinguished in four patients. Conclusion: In RIOAB, by adjusted dosage of AboBTX-A related to the grade of bladder trabeculation, in addition to maintain efficacy, consequent complications might not be affected by dosage and the drug dosage could be increased to nearly 60% with less concern associated to complication