Botulinum injections for the treatment of bladder symptoms of multiple sclerosis
Article first published online: 21 SEP 2007
Copyright © 2007 American Neurological Association
Annals of Neurology
Volume 62, Issue 5, pages 452–457, November 2007
How to Cite
Kalsi, V., Gonzales, G., Popat, R., Apostolidis, A., Elneil, S., Dasgupta, P. and Fowler, C. J. (2007), Botulinum injections for the treatment of bladder symptoms of multiple sclerosis. Ann Neurol., 62: 452–457. doi: 10.1002/ana.21209
- Issue published online: 27 NOV 2007
- Article first published online: 21 SEP 2007
- Manuscript Accepted: 6 JUL 2007
- Manuscript Revised: 29 MAY 2007
- Manuscript Received: 25 JAN 2007
- Multiple Sclerosis Society of Great Britain and Northern Ireland. Grant Number: 799/03
- Pfizer Inc.. Grant Number: Independent Medical Grant 2003-0615
- Department of Health's National Institute for Health Research Biomedical Research Centres funding scheme
Our objective was to demonstrate the efficacy and impact on quality of life of detrusor injections of botulinum neurotoxin type A in the treatment of bladder dysfunction in patients with multiple sclerosis.
Forty-three patients with multiple sclerosis suffering from severe urgency incontinence were treated with detrusor injections of botulinum neurotoxin type A. Data from cystometric assessment of the bladder, voiding diaries, quality-of-life questionnaires, and procontinence medication usage were collected before treatment and 4 and 16 weeks after injection. The same data were also collected after repeat treatments.
Highly significant improvements (p < 0.0001) in incontinence episodes and urinary urgency, daytime frequency and nocturia, were the symptomatic reflection of the significant improvements in urodynamically demonstrated bladder function. Although 98% of patients had to perform self-catheterization after treatment, there were sustained improvements in all quality-of-life scores. The mean duration of effect was 9.7 months. Similar results were seen with repeat treatments.
Minimally invasive injections of botulinum neurotoxin type A have been shown to be exceptionally effective in producing a prolonged improvement in urinary continence in patients with multiple sclerosis. This treatment is likely to have a major impact on future management. Ann Neurol 2007