Treatment Response of Botulinum-A Toxin Intradetusor Injections for Overactive Bladder (OAB) and Neurological Detrusor Overactivity (NDO) Refractory to Anticholinergics and Beta3-Adrenoceptor Agonists

Abstract

Introduction: Overactive bladder (OAB), defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. Methods: A retrospective review of patients getting intradetrusor onabotulinumA injections for OAB and NDO over a 6-year time frame was conducted. The principal outcome measures involved patient’s subjective improvements in OAB and NDO symptoms and the duration of symptomatic relief following every treatment. The secondary results measured relation of patient’s age and duration of each effective treatment cycle. Results: One hundred and thirty-Eight (138) consecutive patients who met the inclusion criteria were included in the study. The average age of women was 59.43 years. Eighty four (61%) of participants were still receiving botox injections while 54 women stopped treatment. The average time period between botulinum A injection and its efficacy in controlling OAB symptoms varied from 3 -8.5 months. There was no decrease in efficacy of the treatment with more cycles of treatment. The average age of women who received one, two, three and four or more cycles were 61.7, 53.87, 63.03, and 56.75 years respectively, which showed with advanced age efficacy of botulinum toxin does not decrease. Conclusions: Our results suggest that in patients who respond to intradetrusor botulinumA treatment, the duration of response does not decline with more treatment cycles, suggesting it as a safe long term treatment option for controlling OAB symptoms. Also there is no relation between advanced age and subsequent efficacy of botulinum A intradetrusor injections.