Onabotulinumtoxin-A improves health status and urinary symptoms in subjects with refractory overactive bladder: Real-life experience.
Τίτλος | Onabotulinumtoxin-A improves health status and urinary symptoms in subjects with refractory overactive bladder: Real-life experience. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Tamburro, F. R., Castellan P., Neri F., Berardinelli F., Bada M., Sountoulides P., Giuliani N., Agrò E. Finazzi, Schips L., & Cindolo L. |
Journal | Urologia |
Volume | 85 |
Issue | 4 |
Pagination | 163-168 |
Date Published | 2018 Nov |
ISSN | 1724-6075 |
Λέξεις κλειδιά | Administration, Intravesical, Adult, Aged, Aged, 80 and over, Botulinum Toxins, Type A, Female, Health Status, Humans, Male, Middle Aged, Patient Satisfaction, Prospective Studies, Self Report, Treatment Outcome, Urinary Bladder, Overactive |
Abstract | OBJECTIVE:: Onabotulinumtoxin-A has been approved for wet overactive bladder refractory to anticholinergics in randomised controlled trials; however, data from real-life practice are scarce. This study was designed to assess the efficacy of intravesical onabotulinumtoxin-A injections, focusing on health status, urinary symptoms and subjective satisfaction.METHODS:: Data from consecutive patients with overactive bladder-refractory to anticholinergics treated with onabotulinumtoxin-A were prospectively collected and analysed. Standard doses (100-150 U) were used, followed by repeat sessions when clinical benefits diminished. Efficacy and safety of repeat onabotulinumtoxin-A administrations were assessed at 12-week post-injection. Clinical parameters evaluated were: change in the magnitude and frequency of incontinence, urgency and nocturia episodes, change in the number of pads used and procedural complications. Quality of life was evaluated using the 36-Item Short-Form Health Survey, Overactive Bladder Screener and Treatment Benefit Scale questionnaires.RESULTS:: Consecutive overactive bladder-refractory to anticholinergics patients ( n = 22) (median duration of oral therapy: 10 months) were enrolled. No intraoperative complications occurred, but two urinary retention cases were recorded. Forty-five percent of patients (10/22) were re-treated (median duration of perceived benefits: 18 months, range: 8-55 months). The number of urinary incontinence, frequency and nocturia episodes, and pads used went from 3.6, 11.3, 2.7 and 2.4 preoperatively to 1.0, 5.8, 0.7 and 0.7 postoperatively ( p < 0.005). Quality of life (36-Item Short-Form Health Survey) was significantly improved and symptom scores (Overactive Bladder Screener) were reduced, from 34.5 to 17.1 at week 12 ( p < 0.05). Eighty-seven percent of patients indicated improvement/great improvement in their condition (Treatment Benefit Scale).CONCLUSION:: Intradetrusor injections of onabotulinumtoxin-A in patients with overactive bladder-refractory to anticholinergics significantly improved health status and urinary symptoms, with high subjective satisfaction. |
DOI | 10.1177/0391560318759258 |
Alternate Journal | Urologia |
PubMed ID | 30426883 |