Botulinum toxin therapy for neurogenic detrusor hyperactivity versus augmentation enterocystoplasty: impact on the quality of life of patients with SCI.
METHODS
Cross-sectional study.


OBJECTIVE
To compare quality of life (QoL) in patients with spinal cord injury (SCI) who underwent overactive detrusor treatment by botulinum toxin (BT) versus augmentation cystoplasty (AC).


METHODS
France.


METHODS
Prospective and descriptive study: Patients with a refractory overactive bladder due to SCI treated by at least two successive injections of BT or by AC. QoL was assessed using Qualiveen-30 (Q30). Clinical data and urodynamic parameters were collected.


RESULTS
Thirty patients were included between March 2013 and March 2014: 14 in arm 1 (BT injections) and 16 in arm 2 (AC). Mean postoperative time after AC was 9.94 years. Mean BT injections already performed was 6.36. Qol was significantly lower in arm 1-Q30 score 1.625 versus arm 2-Q30 score 1.077 (P=0.037). Continence control was significantly higher in arm 2. Fourteen patients were completely continent (87.5%) in arm 2, whereas only 6 (42.3%) were continent in arm 1 (P=0.0187). Urinary infection, reflux, diverticula and stones were almost at a similar occurrence level.


CONCLUSIONS
QoL was found to be higher with an AC compared with BT injections. Long-time intervals between two injections and advantages specific to AC might explain in part these findings.
CHRU Lapeyronie, Service MPR, Montpellier, France.
C
C
Anquetil
Clinique Beausoleil, Service d'Urologie, Montpellier, France.
S
S
Abdelhamid
Rehab Centre CMN Propara, Montpellier, France.
A
A
Gelis
Rehab Centre COS DIVIO, Dijon, France.
C
C
Fattal
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D020895:Enterocytes / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D014563:Urodynamics / Q000187:drug effects; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A