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Organo Oficial de la Sociedad Mexicana de Urología

2010, Number 4

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Rev Mex Urol 2010; 70 (4)

Overactive bladder and botulinum toxin type A management at the Hospital General de México

Pérez RJ, Reyes MA

Language: Spanish
References: 28
Page: 228-242
PDF size: 4069.10 Kb.


ABSTRACT

Background: According to the 2002 definition by the International Continence Society, overactive bladder is a syndrome characterized by micturition urgencyassociated with frequency and nicturia, with or without urge incontinence. There are pharmacological treatments for this disease but refractory cases must be resolved by alternative means. The use of botulinum toxin type A in different doses (200 IU on average) has been reported in the international literature.
Methods: A descriptive study was carried out that included 15 female patients between 29-76 years of age who were diagnosed with drug-refractory overactive bladder. They were treated with 100 IU botulinum toxin type A applied to the detrusor muscle via cystoscopy. All patients had presented with moderate to severe clinical and urodynamic overactive bladder symptoms that importantly affected quality of life. They were evaluated before botulinum toxin application and 2-3 months after treatment by means of medical history, micturition diary, urodynamics (Total Bladder Capacity), assessment with overactive bladder and quality of life questionnaire (Potenziani-QOL-HV-26, 2005) and King’s Health Questionnaire. Statistical analysis of variables was carried out using correlation tests and results were statistically significant.
Results: All 15 patients presented with clinical and urodynamic improvement, but it was greater in those women under 50 years of age. There was a 66.6% improvement in patients in the overactive bladder and quality of life questionnaire, a 25.4% improvement in King’s Health Questionnaire, 80.3% in First Micturition Desire and 92.6% in Total Bladder Capacity.
Conclusions: Medical management with botulinum toxin type A (100 IU) is an effective treatment for drug-refractory overactive bladder. There were no relevant adverse effects. However, the optimum dose of botulinum toxin type A that provides greatest efficiency and safety has yet to be established and so further studies need to be carried out.


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