Botulinum toxin A improves the quality of life of patients with neurogenic urinary incontinence.
OBJECTIVE
To evaluate the impact of botulinum toxin type A (BoNTA) on health-related quality of life in patients with neurogenic urinary incontinence (UI) using the Incontinence Quality of Life questionnaire (I-QOL).


METHODS
Randomized, double-blind, multicenter, placebo-controlled study involving eight centers across Belgium, France, and Switzerland. Patients (n = 59) with UI due to neurogenic detrusor overactivity (spinal cord injury, n = 53; multiple sclerosis, n = 6) who were inadequately managed on oral anticholinergics received a single dose of BoNTA (200U or 300U, Botox) or placebo. I-QOL scores at screening and after treatment at weeks 2, 6, 12, 18, and 24 were recorded.


RESULTS
Median total and subscale I-QOL scores increased significantly from screening with BoNTA 300U compared with placebo at all time points (p<0.05) and with BoNTA 200U compared with placebo at all time points for total score and the Avoidance Limiting Behavior subscale (p<0.05), and at weeks 2, 6, 12, and 18 (p<0.05), but not 24 for the Psychosocial Impact and Social Embarrassment subscales. Approximately twice as many BoNTA recipients as placebo recipients achieved at least a minimal important difference in total I-QOL score at 2, 6, 12, and 24 wk.


CONCLUSIONS
BoNTA significantly improves UI-associated health-related quality of life in patients with neurogenic UI.
Schurch
Brigitte
B
Spinal Cord Injury Center, University Hospital Balgrist, Zurich, Switzerland. schurchb@paralab.balgrist.ch
Denys
Pierre
P
Kozma
Chris M
CM
Reese
Pat Ray
PR
Slaton
Terra
T
Barron
Richard L
RL
D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001743:Urinary Bladder; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000523:psychology
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A