Original Article: Clinical Investigation
Botulinum toxin type A injection for neurogenic detrusor overactivity: Clinical outcome in Japanese patients
Article first published online: 6 NOV 2012
© 2012 The Japanese Urological Association
International Journal of Urology
Special Issue: Lower urinary tract dysfunction: From basic science to clinical management
Volume 20, Issue 1, pages 94–99, January 2013
How to Cite
Hikita, K., Honda, M., Kawamoto, B., Panagiota, T., Inoue, S., Hinata, N., Muraoka, K. and Takenaka, A. (2013), Botulinum toxin type A injection for neurogenic detrusor overactivity: Clinical outcome in Japanese patients. International Journal of Urology, 20: 94–99. doi: 10.1111/j.1442-2042.2012.03218.x
- Issue published online: 2 JAN 2013
- Article first published online: 6 NOV 2012
- Manuscript Accepted: 30 SEP 2012
- Manuscript Received: 29 JUL 2012
- botulinum toxin type A;
- urinary bladder;
- urinary incontinence
To report our experience with intravesical injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis.
Between January 2003 and March 2011, 11 patients (aged 23–75 years) were treated with 40 injections of botulinum toxin type A 300 U. The patients were followed up for 4, 8 and 12 weeks after treatment. The King's Health Questionnaire was administered and cystometric studies were carried out at baseline and 8 weeks after treatment.
A total of six women and five men were treated. Analysis of the King's Health Questionnaire showed a significant improvement in eight of the nine domain scores at 8 weeks from baseline. On cystometric studies, the mean maximum cystometric capacity increased significantly in all patients at 8 weeks from baseline (P < 0.001). Bladder compliance also increased significantly (P < 0.001). The number of urinary incontinence episodes per day improved significantly from baseline after injection (4 weeks, P < 0.001; 8 weeks, P < 0.001; 12 weeks, P < 0.001). Lack of efficacy appeared 7.15 ± 3.4 months after treatment.
Injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis consistently improves bladder control and quality of life.