Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury
ABSTRACT Purpose To assess the response in spinal cord injured patients alternatively treated with different types and dosages of Botulinum neurotoxin type A (BoNT/A) over 15 years. Material and methods Patients who underwent first BoNT/A from 1999-2001 and practiced intermittent catheterization...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
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| Series: | International Brazilian Journal of Urology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382017000400721&lng=en&tlng=en |
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| author | Giuseppe Lombardi Stefania Musco Giovanni Bacci Maria Celso Valerio Bellio Giulio Del Popolo |
| author_facet | Giuseppe Lombardi Stefania Musco Giovanni Bacci Maria Celso Valerio Bellio Giulio Del Popolo |
| author_sort | Giuseppe Lombardi |
| collection | DOAJ |
| description | ABSTRACT Purpose To assess the response in spinal cord injured patients alternatively treated with different types and dosages of Botulinum neurotoxin type A (BoNT/A) over 15 years. Material and methods Patients who underwent first BoNT/A from 1999-2001 and practiced intermittent catheterization were included. Baseline 3-day bladder diary (BD) and urodynamics were collected. BoNT/A failure was defined when patients asked for re-injection ≤ 3 months post-treatment. Criteria for re-injection was at least one daily episode of urinary incontinence at BD. Before re-injection, patients were asked if they had reached 6 months of dryness without antimuscarinics (YES response). Results Overall, 32/60 (53.4%) “No failure” (NF) group; 16 (26.6%) “occasional failure” (OF) and 12 (20%) “consecutive failure” (CF) were included. A total of 822 BoNT/A infiltrations were performed. The mean interval from previous injection to treatment re-scheduling was 8 months. No significant differences between treatments were found within the three groups (p>0.05). The percentage of YES responses increased from 19% (AboBoNT/A 500IU) to 29 % (OnaBoNT/A 300IU) in NF, and from 18% (AboBoNT/A 500IU) to 25% (OnaBoNT/A 300IU) for OF. Five NF cases (15.6%) maintained 6 months of dryness after each injection. Among the baseline variables, only low compliance (< 20mL/cmH2O) was found as predictor for failure (p=0.006). Conclusions Long term BoNT/A for NDO did not increase failures, independent of the types of treatments and switching. Definition of failure and other criteria for continuing repetitive BoNT/A treatment is mandatory. CF was predictable for no response in earlier follow-up. |
| first_indexed | 2024-04-12T07:11:07Z |
| format | Article |
| id | doaj.art-d9474c3b14304b19bbad9899a56ea437 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-12T07:11:07Z |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-d9474c3b14304b19bbad9899a56ea4372022-12-22T03:42:39ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-611943472172910.1590/s1677-5538.ibju.2016.0584S1677-55382017000400721Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injuryGiuseppe LombardiStefania MuscoGiovanni BacciMaria CelsoValerio BellioGiulio Del PopoloABSTRACT Purpose To assess the response in spinal cord injured patients alternatively treated with different types and dosages of Botulinum neurotoxin type A (BoNT/A) over 15 years. Material and methods Patients who underwent first BoNT/A from 1999-2001 and practiced intermittent catheterization were included. Baseline 3-day bladder diary (BD) and urodynamics were collected. BoNT/A failure was defined when patients asked for re-injection ≤ 3 months post-treatment. Criteria for re-injection was at least one daily episode of urinary incontinence at BD. Before re-injection, patients were asked if they had reached 6 months of dryness without antimuscarinics (YES response). Results Overall, 32/60 (53.4%) “No failure” (NF) group; 16 (26.6%) “occasional failure” (OF) and 12 (20%) “consecutive failure” (CF) were included. A total of 822 BoNT/A infiltrations were performed. The mean interval from previous injection to treatment re-scheduling was 8 months. No significant differences between treatments were found within the three groups (p>0.05). The percentage of YES responses increased from 19% (AboBoNT/A 500IU) to 29 % (OnaBoNT/A 300IU) in NF, and from 18% (AboBoNT/A 500IU) to 25% (OnaBoNT/A 300IU) for OF. Five NF cases (15.6%) maintained 6 months of dryness after each injection. Among the baseline variables, only low compliance (< 20mL/cmH2O) was found as predictor for failure (p=0.006). Conclusions Long term BoNT/A for NDO did not increase failures, independent of the types of treatments and switching. Definition of failure and other criteria for continuing repetitive BoNT/A treatment is mandatory. CF was predictable for no response in earlier follow-up.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382017000400721&lng=en&tlng=enBotulinum Toxins, Type ASpinal Cord CompressionUrinary Bladder, Neurogenic |
| spellingShingle | Giuseppe Lombardi Stefania Musco Giovanni Bacci Maria Celso Valerio Bellio Giulio Del Popolo Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury International Brazilian Journal of Urology Botulinum Toxins, Type A Spinal Cord Compression Urinary Bladder, Neurogenic |
| title | Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury |
| title_full | Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury |
| title_fullStr | Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury |
| title_full_unstemmed | Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury |
| title_short | Long-term response of different Botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury |
| title_sort | long term response of different botulinum toxins in refractory neurogenic detrusor overactivity due to spinal cord injury |
| topic | Botulinum Toxins, Type A Spinal Cord Compression Urinary Bladder, Neurogenic |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382017000400721&lng=en&tlng=en |
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