Effect of repeated detrusor onabotulinumtoxina injections on bladder and renal function in patients with chronic spinal cord injuries

• Published in: Neurourology and urodynamics 2011-11, Vol.30 (8), p.1541-1545
• Main Authors: Kuo, Hann-Chorng, Liu, Shu-Hsin
• Format: Article
• Language: English
• Subjects: Administration, Intravesical; Adolescent; Adult; Botulinum Toxins, Type A - administration & dosage; Chronic Disease; detrusor sphincter dyssynergia; Drug Administration Schedule; Female; Glomerular Filtration Rate - drug effects; Humans; Intermittent Urethral Catheterization; Kidney - diagnostic imaging; Kidney - drug effects; Kidney - innervation; Kidney - physiopathology; Male; Middle Aged; neurogenic bladder; Neuromuscular Agents - administration & dosage; Pilot Projects; Pressure; Quality of Life; Radionuclide Imaging; Radiopharmaceuticals; renal function; Spinal Cord Injuries - complications; Spinal Cord Injuries - physiopathology; spinal cord injury; Surveys and Questionnaires; Taiwan; Technetium Tc 99m Pentetate; Time Factors; Treatment Outcome; Urinary Bladder - drug effects; Urinary Bladder - innervation; Urinary Bladder - physiopathology; Urinary Bladder, Neurogenic - drug therapy; Urinary Bladder, Neurogenic - etiology; Urinary Bladder, Neurogenic - physiopathology; Urinary Incontinence - drug therapy; Urinary Incontinence - etiology; Urinary Incontinence - physiopathology; Urodynamics - drug effects; Young Adult
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.21146

Aims To investigate the therapeutic effects of repeated detrusor onabotulinumtoxinA injections on urinary incontinence and renal function in patients with chronic spinal cord injuries (SCI). Methods Patients with suprasacral SCI were enrolled. OnabotulinumtoxinA 200 U detrusor injections were repeated every 6 months for four times. Patients were instructed to perform clean intermittent catheterization during the treatment and follow‐up periods. Videourodynamic study and 99mTc‐DTPA renal scanning for glomerular filtration rate (GFR) were performed at screening and every 3 months to assess the therapeutic effects on bladder and renal function. Quality of life was measured by the UDI‐6, IIQ‐7, and self‐assessed QoL indices. Adverse events were also recorded. Results A total of 33 patients completed the study, 30 had improvement in incontinence grade (n = 18) or became completely dry (n = 12) after initial and subsequent onabotulinumtoxinA injections. Mean bladder capacity increased from 207 ± 111 to 412 ± 33 ml and mean detrusor pressure decreased from 39.8 ± 21.7 to 20.6 ± 19.1 cmH2O (all P