title: Repeat botulinum toxin-A injections for treatment of adult detrusor overactivity.
abstract: Intravesical injections of botulinum toxin-A have become established as an effective therapy in the management of neurogenic and idiopathic detrusor overactivity that is refractory to treatment with anticholinergic medication. The effects of the toxin are finite and repeated injections are required to sustain the beneficial therapeutic effects. The available data suggest a reproducible and sustained improvement in symptoms as well as urodynamic parameters following repeated injections of botulinum toxin-A. The reported incidence of adverse events is low and resistance to the toxin is uncommon. The timing of repeat injections within the published data is variable, reflecting differing practise among clinicians, but is typically 6-12 months. Larger scale studies are still required to clarify the usefulness of botulinum toxin-A as a long-term treatment in the management of detrusor overactivity.
authors.affiliation: Department of Urology, Medical Research Council, Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital, Great Maze Pond, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dowson
authors.forename: Mohammad Shamim
authors.initials: MS
authors.lastname: Khan
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.forename: Arun
authors.initials: A
authors.lastname: Sahai
mesh_terms: D000283:Administration, Intravesical; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D004351:Drug Resistance; D006801:Humans; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019233:Retreatment; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A