title: Intradetrusor injection of botulinum-A toxin in patients with idiopathic and neurogenic detrusor overactivity: urodynamic outcome and patient satisfaction.
abstract: OBJECTIVE
  To assess and compare the efficacy of botulinum-A toxin (BTX-A) injections into the detrusor in idiopathic and neurogenic detrusor overactivity (IDO and NDO) resistant to anticholinergic treatment with respect to patient satisfaction.
  
  
  METHODS
  In a prospective study, 16 patients with IDO and 14 with NDO resistant to anticholinergic treatment were injected with 500 U of Dysport into the detrusor. Clinical, urodynamic, and satisfaction assessments were performed at baseline and after BTX-A injections.
  
  
  RESULTS
  In IDO as well as in NDO, there was a significant increase in median maximum cystometric capacity (MCC) from 177.5 to 262.5 ml (P<0.0005) and 160 to 270 ml (P=0.001), median bladder compliance from 24.5 to 40.0 ml/cmH2O (P<0.0005) and 25.5 to 44.0 ml/cmH2O (P=0.001) and median PVR from 15 to 80 ml (P=0.001) and 15.0 to 62.5 ml (P=0.001), respectively. Median Pdet max decreased significantly from 49 to 37 cmH2O (P<0.0005) and 48.5 to 37.0 cmH2O (P=0.001), and median Pdet Qmax from 32.0 to 20.0 ml/sec (P<0.0005) and 36.0 to 21.5 ml/sec (P=0.001), respectively. The effect of BTX-A injections lasted for a median time of 5 months in both groups. Median daytime frequency, nocturia, and number of used pads decreased significantly in both groups. More than 80% of the patients were satisfied with the effect of BTX-A.
  
  
  CONCLUSIONS
  Patients with intractable IDO respond to intradetrusor BTX-A with a significant and comparable but temporally limited effect in urodynamic and LUTS parameters as those with NDO. The majority of patients were satisfied with treatment.
authors.affiliation: Faculty of Medicine, Jordan University of Science & Technology, King Abdullah University Hospital, Irbid, Jordan.
authors.forename: Ibrahim Fathi
authors.initials: IF
authors.lastname: Ghalayini
authors.affiliation: Faculty of Medicine, Jordan University of Science & Technology, King Abdullah University Hospital, Irbid, Jordan.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Al-Ghazo
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology*; D014563:Urodynamics / Q000187:drug effects / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents; D018680:Cholinergic Antagonists; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A