Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience

Purpose To evaluate intravesical loss of onabolunumtoxinA (onaBTA) during endoscopic injection into the bladder wall for treatment of neurogenic detrusor overactivity (NDO). The intraluminal loss of onaBTA cannot be determined directly, therefore we added methylene blue (MB) to reconstitute onaBTA....

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Main Authors: Vladimír Šámal, Jan Krhut, Vít Paldus, Jana Műllerová, Jan Mečl
Format: Article
Language:English
Published: Korean Continence Society 2020-03-01
Series:International Neurourology Journal
Subjects:
Online Access:http://www.einj.org/upload/pdf/inj-1938160-080.pdf
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author Vladimír Šámal
Jan Krhut
Vít Paldus
Jana Műllerová
Jan Mečl
author_facet Vladimír Šámal
Jan Krhut
Vít Paldus
Jana Műllerová
Jan Mečl
author_sort Vladimír Šámal
collection DOAJ
description Purpose To evaluate intravesical loss of onabolunumtoxinA (onaBTA) during endoscopic injection into the bladder wall for treatment of neurogenic detrusor overactivity (NDO). The intraluminal loss of onaBTA cannot be determined directly, therefore we added methylene blue (MB) to reconstitute onaBTA. Subsequently we used spectrophotometry to determine the total amount of MB in the irrigation fluid, which allowed us to calculate total intraluminal loss of onaBTA. Methods The study population was consisted of 48 patients with NDO. The mean age was 36.6±8.9 years. Forty-two patients suffered from NDO due to spinal cord injury and 6 patients suffered from multiple sclerosis. Each patient received 200 units of onaBTA administered by 30 endoscopic injections (1 mL per injection) using a 23-G needle. The entire volume of irrigation fluid was collected and spectrophotometry was used to determine the MB concentration. The total amount of injected onaBTA, total amount of irrigation solution and the known amount of MB used during reconstitution, allowed for the determination of intravesical loss of onaBTA. Results Forty-five patients were included in the final analysis. The mean volume of irrigation fluid was 603.33±400.14 mL. The mean absorbance was 0.14±0.12 with the mean MB concentration 0.19±0.18 mg/L. The mean calculated loss of onaBTA was 4.14±4.11 units. Conclusions The endoscopic injection of onaBTA marked by MB into the bladder wall is associated with minimal intravesical loss of the agent, representing less than 3% of the administered dose of MB. This may reflect the amount of the onaBTA detected in the irrigation fluid.
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spelling doaj.art-8ecabf904a174f1599aedf069b9e4a002022-12-22T03:39:51ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312020-03-01241596510.5213/inj.1938160.080837Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter ExperienceVladimír Šámal0Jan Krhut1Vít Paldus2Jana Műllerová3Jan Mečl4 Department of Urology, Regional Hospital Liberec, Liberec, Czech Republic Department Of Urology, University Hospital Ostrava, Ostrava, Czech Republic Department of Urology, Regional Hospital Liberec, Liberec, Czech Republic Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic Department of Urology, Regional Hospital Liberec, Liberec, Czech RepublicPurpose To evaluate intravesical loss of onabolunumtoxinA (onaBTA) during endoscopic injection into the bladder wall for treatment of neurogenic detrusor overactivity (NDO). The intraluminal loss of onaBTA cannot be determined directly, therefore we added methylene blue (MB) to reconstitute onaBTA. Subsequently we used spectrophotometry to determine the total amount of MB in the irrigation fluid, which allowed us to calculate total intraluminal loss of onaBTA. Methods The study population was consisted of 48 patients with NDO. The mean age was 36.6±8.9 years. Forty-two patients suffered from NDO due to spinal cord injury and 6 patients suffered from multiple sclerosis. Each patient received 200 units of onaBTA administered by 30 endoscopic injections (1 mL per injection) using a 23-G needle. The entire volume of irrigation fluid was collected and spectrophotometry was used to determine the MB concentration. The total amount of injected onaBTA, total amount of irrigation solution and the known amount of MB used during reconstitution, allowed for the determination of intravesical loss of onaBTA. Results Forty-five patients were included in the final analysis. The mean volume of irrigation fluid was 603.33±400.14 mL. The mean absorbance was 0.14±0.12 with the mean MB concentration 0.19±0.18 mg/L. The mean calculated loss of onaBTA was 4.14±4.11 units. Conclusions The endoscopic injection of onaBTA marked by MB into the bladder wall is associated with minimal intravesical loss of the agent, representing less than 3% of the administered dose of MB. This may reflect the amount of the onaBTA detected in the irrigation fluid.http://www.einj.org/upload/pdf/inj-1938160-080.pdfbotulinum toxins, type aurinary bladder, neurogenicintravesical injectionmethylene bluespectrophotometry
spellingShingle Vladimír Šámal
Jan Krhut
Vít Paldus
Jana Műllerová
Jan Mečl
Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience
International Neurourology Journal
botulinum toxins, type a
urinary bladder, neurogenic
intravesical injection
methylene blue
spectrophotometry
title Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience
title_full Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience
title_fullStr Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience
title_full_unstemmed Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience
title_short Intravesical Loss of OnabotulinumtoxinA During Endoscopic Intradetrusor Injection - A Multicenter Experience
title_sort intravesical loss of onabotulinumtoxina during endoscopic intradetrusor injection a multicenter experience
topic botulinum toxins, type a
urinary bladder, neurogenic
intravesical injection
methylene blue
spectrophotometry
url http://www.einj.org/upload/pdf/inj-1938160-080.pdf
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