Arterial hypertension related to the injection of onabotulinumtoxinA in the detrusor.
OBJECTIVE
We want to report on a first case reported of a 50-year-old female with repetitive and clinical significant hypertension after each injection of onabotulinumtoxinA. This is a retrospective chart review and prospective evaluation of the natriuresis and blood pressure at baseline and after injection therapy. The aim was to explore the mechanism of action of this apparent onabotulinumtoxinA related hypertension.


METHODS
Retrospectively hypertension appeared after 7 days and vanished after 4-5 months following injection of 300 units of onabotulinumtoxinA in the detrusor, bladder symptoms disappeared after 2 weeks and reoccurred after 5 months. Urological, nephrological, cardiological and endocrinological evaluations were normal.


METHODS
In the prospective evaluation a 3-day bladder diary at baseline revealed a bladder capacity of 131 ± 57 ml and at 1 month when full effect was experienced 173 ± 50 ml. At 1 month there were no leakages with six episodes of intermittent catheterization per day. The 24-hour blood pressure registration demonstrated the onset of hypertension at day 7 together with a reversal of the urinary sodium/creatinine ratios on the renal function profile.


CONCLUSIONS
The increasing natriuresis coinciding with the hypertension is a normal compensatory mechanism suggesting that the hypertension has a central cause rather than it is caused by haematogenous spreading.
K
K
Everaert
A S
AS
Goessaert
J
J
Vande Walle
D000959:Antihypertensive Agents / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy / Q000652:urine; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine
D000959:Antihypertensive Agents; D019274:Botulinum Toxins, Type A
Hypertension,; Incontinence,; Kidney function,; OnabotulinumtoxinA,; Overactive bladder syndrome