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Diabetes mellitus does not affect the efficacy and safety of intravesical onabotulinumtoxina injection in patients with refractory detrusor overactivity

Authors

  • Chung-Cheng Wang,

    1. Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
    2. Department of Biomedical Engineering, Chung Yuan Christian University, Chung-Li, Taiwan
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  • Chun-Hou Liao,

    1. Department of Urology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
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  • Hann-Chorng Kuo

    Corresponding author
    1. Department of Urology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
    • Correspondence to: Hann-Chorng Kuo, M.D., Department of Urology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, Hualien, Taiwan. E-mail: hck@tzuchi.com.tw

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  • Roger Dmochowski led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: none.
  • Author contributions: H.C.K. conceived and designed the experiments; C.C.W. and H.C.K. performed the experiments; C.C.W., C.H.L., and H.C.K. analyzed the data; H.C.K. contributed reagents/materials/analysis tools; C.C.W., C.H.L., and H.C.K. wrote the paper.

Abstract

Aims

To investigate the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with diabetes mellitus (DM) and refractory detrusor overactivity (DO).

Methods

Forty-eight type 2 DM patients with refractory DO received intravesical 100 U onabotulinumtoxinA injection. Another 48 age-matched patients were randomly selected from a non-diabetic group as controls. Video-urodynamic studies were performed at baseline and were repeated 3 months after treatment. The treatment outcomes were graded on the basis of changes in the Patient's Perception of Bladder Condition (PPBC) and a PPBC decrease of 2 or more points was considered successful. Treatment-related adverse events including acute urinary retention, large post-voiding residual (PVR) volumes, straining to void, urinary tract infection, hematuria, and general weakness were recorded.

Results

The mean ages of the diabetic and non-diabetic patients were 73.1 ± 8.8 and 72.0 ± 9.3 (P = 0.552), respectively. The changes of urodynamic parameters were comparable between the two groups. Similar successful results were noted at the 6-month follow-up (DM, 56% vs. non-DM, 61%, P = 0.128). Diabetic patients had a significantly greater incidence of large PVR volumes (DM, 60.4% vs. non-DM, 33.3%; P = 0.007) and general weakness (DM, 10.4% vs. non-DM, 0%; P = 0.03) after treatment. Baseline urodynamic parameters in diabetic patients did not predict the occurrence of adverse events. No major complication was noted in either group.

Conclusions

Intravesical onabotulinumtoxinA injection is a safe and effective treatment for DM patients with refractory DO. Patients with DM should be informed of the increased risk of large PVR before initiation of treatment. Neurourol. Urodynam. 33:1235–1239, 2014. © 2013 Wiley Periodicals, Inc.

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