Botulinum toxin (OnabotulinumtoxinA) in the male non‐neurogenic overactive bladder: clinical and quality of life outcomes

• Published in: BJU international 2015-10, Vol.116 (S3), p.61-65
• Main Authors: Habashy, David, Losco, Giovanni, Tse, Vincent, Collins, Ruth, Chan, Lewis
• Format: Article
• Language: English
• Subjects: Acetylcholine Release Inhibitors - administration & dosage; Acetylcholine Release Inhibitors - adverse effects; Acetylcholine Release Inhibitors - therapeutic use; Administration, Intravesical; Adult; Aged; Aged, 80 and over; Botulinum toxins, type A; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - adverse effects; Botulinum Toxins, Type A - therapeutic use; Humans; lower urinary tract symptoms; Male; Middle Aged; Prostatectomy; prostatic neoplasms; Quality of Life - psychology; Retrospective Studies; Transurethral Resection of Prostate; Treatment Outcome; Urinary Bladder, Neurogenic; urinary bladder, overactive; Urinary Bladder, Overactive - drug therapy; Urinary Bladder, Overactive - psychology; Urinary Incontinence - drug therapy; urinary incontinence, stress
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/bju.13110

Objective To assess the efficacy of OnabotulinumtoxinA (BTXA) injections in men with drug‐refractory non‐neurogenic overactive bladder (NNOAB). Patients and Methods A total of 43 men received BTXA injections for NNOAB from 2004 to 2012. Patient Global Impression of Improvement (PGI‐I) score was obtained. For men with wet NNOAB, change in number of pads per day was also assessed. Results Forty‐three men with a mean age of 69 (range 37–85) received at least one injection. Of the 43 men, 20 (47%) had prior prostate surgery: 11 had radical prostatectomy (RP) and nine had transurethral resection of prostate (TURP). Overall, average PGI‐I score was 2.7. Comparing PGI‐I score in men who had prior prostate surgery with men who have not: 2.6 ± 0.5 vs 2.8 ± 0.5 respectively (average ± 95% CI), P = 0.6. Comparing PGI‐I score in men who had previous TURP with men who had previous RP: PGI‐I score: 3.3 ± 0.8 vs 2.0 ± 0.5 respectively, P < 0.05. Men who had RP experienced a reduction in pad use (from 3.5 ± 1.7 to 1.6 ± 0.9 pads/day, P < 0.05) while this was not the case amongst men who had TURP (from 1.7 ± 1.5 to 1.4 ± 1.5 pads/day, P = 0.4). Conclusion Overall, BTXA injection in men with drug‐refractory NNOAB does provide a symptomatic benefit. Amongst men who have had prior prostate surgery, men who have had RP experience a greater benefit than men who have had TURP, both in regards to PGI‐I score and pad use.