title: Long-term compliance and results of intravesical botulinum toxin A injections in male patients.
abstract: BACKGROUND
  Intravesical injections with botulinum toxin A (BoNT-A) is an established treatment for patients with overactive bladder (OAB) symptoms. However, most studies have evaluated the efficacy of this treatment in women and report short-term results. In this study, we evaluated the long-term compliance of BoNT-A in a heterogeneous group of male patients.
  
  
  METHODS
  This is a retrospective, single-centre study. We evaluated all male patients who have been treated with BoNT-A from 2004 until 2010 in a large teaching hospital. Patients received 100-300 U of onabotulinum toxin-A in 20 intravescial injections. Some patients received dose adjustment with repeated injections.
  
  
  RESULTS
  In total, 88 male patients were included. The mean follow-up was almost 6 years (69 months). Of all patients, 22 (25%) continued BoNT-A treatment at last follow-up (success). Of the patients who discontinued treatment, 35 had insufficient effect and 27 had tolerability issues (eg, urinary retention, self-catheterisation, voiding LUTS). Four patients abandoned treatment due to other reasons that were not related to BoNT-A. Of all patients, 24% had to use intermittent catheterisation (de novo) or indwelling catheters at some point during the follow-up.
  
  
  CONCLUSIONS
  In this real-life, heterogeneous cohort of men, the long-term compliance with BoNT-A was 25%. Patients with neurogenic OAB symptoms appear to have the best results in our study with 36% of patients who were still on active treatment during last follow-up. Intravesical BoNT-A can be an effective treatment for men with OAB symptoms. In our study, only 25% of patients continued treatment during long-term follow-up. Larger, prospective trials are needed to confirm these results.
authors.affiliation: Department of Urology, Zuyderland Medical Centre, Heerlen, The Netherlands.|Maastricht University, Maastricht, The Netherlands.
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Rahnama'i
authors.affiliation: Department of Urology, Zuyderland Medical Centre, Heerlen, The Netherlands.
authors.forename: Tom A T
authors.initials: TAT
authors.lastname: Marcelissen
authors.affiliation: Maastricht University, Maastricht, The Netherlands.
authors.forename: Beverley
authors.initials: B
authors.lastname: Brierley
authors.affiliation: Service de Neuro-Réhabilitation, CHUV, Lausanne, Suisse.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schurch
authors.affiliation: Department of Urology, Zuyderland Medical Centre, Heerlen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Vries
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000009:adverse effects; D010349:Patient Compliance; D011183:Postoperative Complications / Q000188:drug therapy*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000209:etiology; D016055:Urinary Retention / Q000139:chemically induced
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: botox; botulinium toxine A; detrusor overactivity; male; men; overactive bladder syndrome; urgency