Real-Life Treatment Outcome of Botulinum Toxin A Injection on Overactive Bladder and Voiding Dysfunction in Patients with Central Nervous System Lesions
Abstract
:1. Introduction
2. Results
2.1. Detrusor BoNT-A Injection for OAB
2.2. Urethral Sphincter BoNT-A Injection for Voiding Dysfunction
2.3. Satisfaction and Repeated BoNT-A Injections
3. Discussion
4. Conclusions
5. Materials and Methods
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Griffiths, D.; Derbyshire, S.; Stenger, A.; Resnick, N. Brain control of normal and overactive bladder. J. Urol. 2005, 174, 1862–1867. [Google Scholar] [CrossRef] [PubMed]
- Tudor, K.I.; Sakakibara, R.; Panicker, J.N. Neurogenic lower urinary tract dysfunction: Evaluation and management. J. Neurol. 2016, 263, 2555–2564. [Google Scholar] [CrossRef] [PubMed]
- Griffiths, D.J.; McCracken, P.N.; Harrison, G.M.; Gormley, E.A.; Moore, K.; Hooper, R.; McEwan, A.J.B.; Triscott, J. Cerebral aetiology of urinary urge incontinence in elderly people. Age Ageing 1994, 23, 246–250. [Google Scholar] [CrossRef] [PubMed]
- Del-Ser, T.; Munoz, D.G.; Hachinski, V. Temporal pattern of cognitive decline and incontinence is different in Alzheimer’s disease and diffuse Lewy body disease. Neurology 1996, 46, 682–686. [Google Scholar] [CrossRef] [PubMed]
- Pettersen, R.; Stien, R.; Wyller, T.B. Post-stroke urinary incontinence with impaired awareness of the need to void: Clinical and urodynamic features. BJU Int. 2007, 99, 1073–1077. [Google Scholar] [CrossRef]
- Bapir, R.; Bhatti, K.H.; Eliwa, A.; García-Perdomo, H.A.; Gherabi, N.; Hennessey, D.; Magri, V.; Mourmouris, P.; Ouattara, A.; Perletti, G.; et al. Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials. Arch. Ital. Urol. Androl. 2022, 94, 492–506. [Google Scholar] [CrossRef]
- Peyronnet, B.; Lapitan, M.C.; Tzelves, L.; O’Connor, E.; Nic An Riogh, A.; Manso, M.; Yuan, C.Y.; Arlandis, S.; Bo, K.; Costantini, E.; et al. Benefits and harms of conservative, pharmacological, and surgical management options for women with bladder outlet obstruction: A systematic review from the European Association of Urology Non-neurogenic Female LUTS Guidelines Panel. Eur. Urol. Focus. 2022, 8, 1340–1361. [Google Scholar] [CrossRef]
- Cohn, J.A.; Brown, E.T.; Reynolds, W.S.; Kaufman, M.R.; Dmochowski, R.R. Pharmacologic management of non-neurogenic functional obstruction in women. Expert. Opin. Drug Metab. Toxicol. 2016, 12, 657–667. [Google Scholar] [CrossRef]
- Cruz, F. Targets for botulinum toxin in the lower urinary tract. Neurourol. Urodyn. 2014, 33, 31–38. [Google Scholar] [CrossRef]
- Apostolidis, A.; Dasgupta, P.; Fowler, C.J. Proposed mechanism for the efficacy of injected botulinum toxin in the treatment of human detrusor overactivity. Eur. Urol. 2006, 49, 644–650. [Google Scholar] [CrossRef]
- Lightner, D.J.; Gomelsky, A.; Souter, L.; Vasavada, S.P. Diagnosis and treatment of overactive bladder (Non-Neurogenic) in adults: AUA/SUFU guideline amendment 2019. J. Urol. 2019, 202, 558–563. [Google Scholar] [CrossRef]
- Chapple, C.; Sievert, K.D.; MacDiarmid, S.; Khullar, V.; Radziszewski, P.; Nardo, C.; Thompson, C.; Zhou, J.; Haag-Molkenteller, C. OnabotulinumtoxinA 100 U significantly improves all idiopathic overactive bladder symptoms and quality of life in patients with overactive bladder and urinary incontinence: A randomised, double-blind, placebo-controlled trial. Eur. Urol. 2013, 64, 249–256. [Google Scholar] [CrossRef] [PubMed]
- Truzzi, J.C.; Lapitan, M.C.; Truzzi, N.C.; Iacovelli, V.; Averbeck, M.A. Botulinum toxin for treating overactive bladder in men: A systematic review. Neurourol. Urodyn. 2022, 41, 710–723. [Google Scholar] [CrossRef] [PubMed]
- Apostolidis, A.; Dasgupta, P.; Denys, P.; Elneil, S.; Fowler, C.J.; Giannantoni, A.; Karsenty, G.; Schulte-Baukloh, H.; Schurch, B.; Wyndaele, J.-J. Recommendations on the use of botulinum toxin in the treatment of lower urinary tract disorders and pelvic floor dysfunctions: A European consensus report. Eur. Urol. 2009, 55, 100–119. [Google Scholar] [CrossRef] [PubMed]
- Linsenmeyer, T.A. Post-CVA voiding dysfunctions: Clinical insights and literature review. NeuroRehabilitation 2012, 30, 1–7. [Google Scholar] [CrossRef] [PubMed]
- Araki, I.; Kitahara, M.; Oida, T.; Kuno, S. Voiding dysfunction and Parkinson’s disease: Urodynamic abnormalities and urinary symptoms. J. Urol. 2000, 164, 1640–1643. [Google Scholar] [CrossRef] [PubMed]
- Choi, J.B. Dementia and voiding dysfunction. J. Korean Cont. Soc. 2008, 12, 10–18. [Google Scholar] [CrossRef]
- Williams, M.P.; Srikanth, V.; Bird, M.; Thrift, A.G. Urinary symptoms and natural history of urinary continence after first-ever stroke—A longitudinal population-based study. Age Ageing 2012, 41, 371–376. [Google Scholar] [CrossRef]
- Sakakibara, R.; Hattori, T.; Yasuda, K.; Yamanishi, T. Micturitional disturbance after acute hemispheric stroke: Analysis of the lesion site by CT and MRI. J. Neurol. Sci. 1996, 137, 47–56. [Google Scholar] [CrossRef]
- Pettersen, R.; Wyller, T.B. Prognostic significance of micturition disturbances after acute stroke. J. Am. Geriatr. Soc. 2006, 54, 1878–1884. [Google Scholar] [CrossRef]
- Lang, A.E.; Lozano, A.M. Parkinson’s disease. Second of two parts. N. Engl. J. Med. 1998, 339, 1130–1143. [Google Scholar] [CrossRef] [PubMed]
- Galloway, N.T. Urethral sphincter abnormalities in Parkinsonism. Br. J. Urol. 1983, 55, 691–693. [Google Scholar] [CrossRef] [PubMed]
- Lee, Y.H.; Lee, J.E.; Ryu, D.W.; Oh, Y.S.; Lee, K.S.; Hong, S.H.; Kim, J.S. Urinary dysfunctions and post-void residual urine in typical and atypical Parkinson diseases. J. Park. Dis. 2018, 8, 145–152. [Google Scholar] [CrossRef] [PubMed]
- Akhavan-Sigari, R.; Mortzavi-Zadeh, P.; Trakolis, L.; Keyhan, H.; Amend, B.; Herlan, S. The connection between frontal lobe brain tumors and lower urinary tract symptoms—Series of 347 patients. Eur. Rev. Med. Pharmacol. Sci. 2021, 25, 654–660. [Google Scholar] [CrossRef] [PubMed]
- Jiang, Y.H.; Liao, C.H.; Tang, D.L.; Kuo, H.C. Efficacy and safety of intravesical onabotulinumtoxinA injection on elderly patients with chronic central nervous system lesions and overactive bladder. PLoS ONE 2014, 9, e105989. [Google Scholar] [CrossRef] [PubMed]
- Hu, J.C.; Hsu, L.N.; Lee, W.C.; Chuang, Y.C.; Wang, H.J. Role of urological botulinum toxin-A injection for overactive bladder and voiding dysfunction in patients with Parkinson’s disease or post-stroke. Toxins 2023, 15, 166. [Google Scholar] [CrossRef] [PubMed]
- Lee, H.Y.; Kuo, H.C. Intravesical injection of botulinum toxin type A in men without bladder outlet obstruction and post-deobstructive prostate surgery. Toxins 2023, 15, 221. [Google Scholar] [CrossRef]
- Jiang, Y.H.; Jhang, J.F.; Kuo, H.C. The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis. Tzu Chi Med. J. 2023, 35, 31–37. [Google Scholar] [CrossRef]
- Nitti, V.; Haag-Molkenteller, C.; Kennelly, M.; Chancellor, M.; Jenkins, B.; Schurch, B. Treatment of neurogenic detrusor overactivity and overactive bladder with Botox (onabotulinumtoxinA): Development, insights, and impact. Medicine 2023, 102, e32377. [Google Scholar] [CrossRef]
- Kaviani, A.; Khavari, R. Disease-specific outcomes of botulinum toxin injections for neurogenic detrusor overactivity. Urol. Clin. North. Am. 2017, 44, 463. [Google Scholar] [CrossRef]
- Vurture, G.; Peyronnet, B.; Feigin, A.; Biagioni, M.C.; Gilbert, R.; Rosenblum, N.; Frucht, S.; Di Rocco, A.; Nitti, V.W.; Brucker, B.M. Outcomes of intradetrusor onabotulinum toxin A injection in patients with Parkinson’s disease. Neurourol. Urodyn. 2018, 37, 2669–2677. [Google Scholar] [CrossRef] [PubMed]
- Atamian, A.; Sichez, P.C.; Michel, F.; Bandelier, Q.; Fall, M.; Gaillet, S.; Azoulay, J.; Lechevallier, E.; Karsenty, G. Intradetrusor injections of botulinum toxin A to treat urinary incontinence due to bladder overactivity during idiopathic Parkinson’s disease. Prog. Urol. 2021, 31, 430–438. [Google Scholar] [CrossRef]
- Hajebrahimi, S.; Chapple, C.R.; Pashazadeh, F.; Salehi-Pourmehr, H. Management of neurogenic bladder in patients with Parkinson’s disease: A systematic review. Neurourol. Urodyn. 2019, 38, 31–62. [Google Scholar] [CrossRef]
- Zillioux, J.; Welk, B.; Suskind, A.M.; Gormley, E.A.; Goldman, H.B. SUFU white paper on overactive bladder anticholinergic medications and dementia risk. Neurourol. Urodyn. 2022, 41, 1928–1933. [Google Scholar] [CrossRef] [PubMed]
- Jiang, Y.H.; Chen, S.F.; Kuo, H.C. Frontiers in the clinical applications of botulinum toxin A as treatment for neurogenic lower urinary tract dysfunction. Int. Neurourol. J. 2020, 24, 301–312. [Google Scholar] [CrossRef]
- Anderson, R.U.; Orenberg, E.K.; Glowe, P. OnabotulinumtoxinA office treatment for neurogenic bladder incontinence in Parkinson’s disease. Urology 2014, 83, 22–27. [Google Scholar] [CrossRef] [PubMed]
- Baron, M.; Peyronnet, B.; Aublé, A.; Hascoet, J.; Castel-Lacanal, E.; Miget, G.; Le Doze, S.; Prudhomme, T.; Manunta, A.; Cornu, J.-N.; et al. Long-term discontinuation of botulinum toxin A intradetrusor injections for neurogenic detrusor overactivity: A multicenter study. J. Urol. 2019, 201, 769–776. [Google Scholar] [CrossRef]
- Gallien, P.; Reymann, J.M.; Amarenco, G.; Nicolas, B.; de Sèze, M.; Bellissant, E. Placebo controlled, randomised, double blind study of the effects of botulinum A toxin on detrusor sphincter dyssynergia in multiple sclerosis patients. J. Neurol. Neurosurg. Psychiatry 2005, 76, 1670–1676. [Google Scholar] [CrossRef]
- Kuo, Y.C.; Kuo, H.C. Comparative study of different combinations of mirabegron and antimuscarinics in treatment for overactive bladder syndrome in elderly. Tzu Chi Med. J. 2023, 35, 62–68. [Google Scholar] [CrossRef]
Treatment Outcome | CVA (n = 36) | PD (n = 13) | Dementia (n = 25) | Total (n = 74) | p Value |
---|---|---|---|---|---|
Age | 61.2 ± 14.2 | 77.8 ± 5.8 | 73.1 ± 6.6 | 68.1 ± 12.8 | 0.000 |
Dry | 11 (30.6%) | 4 (30.8%) | 6 (24.0%) | 21 (28.4%) | 0.894 |
Improved | 20 (55.6%) | 6 (46.2%) | 14 (56.0%) | 40 (54.1%) | |
Failed | 5 (13.9%) | 3 (23.1%) | 5 (20.0%) | 13 (17.6%) | |
Difficult urination | 24 (66.7%) | 5 (38.5%) | 15 (60%) | 44 (59.5%) | 0.206 |
AUR | 5 (13.9%) | 0 | 2 (8.0%) | 7 (9.5%) | 0.454 |
UTI | 8 (22.2%) | 0 | 3 (12.0%) | 11 (14.9%) | 0.171 |
PVR (% CBC) | 48.7 ± 23.5 | 30.4 ± 17.1 | 45.2 ± 23.3 | 44.3 ± 23.2 | 0.047 |
VE (% CBC) | 51.3 ± 23.6 | 68.9 ± 18.7 | 54.8 ± 23.3 | 55.5 ± 23.3 | 0.063 |
Duration (mean ± SD) | 7.72 ± 6.16 | 6.46 ± 6.46 | 4.56 ± 3.69 | 6.43 ± 5.62 | 0.095 |
DO (n = 66) | DO + DU (n = 8) | p Value | USD (n = 6) | Non-USD (n = 68) | p Value | |
---|---|---|---|---|---|---|
Dry | 21 (31.8%) | 0 | 0.060 | 1 (16.7%) | 20 (29.4%) | 0.529 |
Improved | 35 (53.0%) | 5 (62.5%) | 5 (83.3%) | 35 (51.5%) | ||
Failed | 10 (15.2%) | 3 (37.5%) | 0 | 13 (19.1%) | ||
Difficult urination | 37 (56.1%) | 7 (87.5%) | 0.132 | 4 (66.7%) | 40 (58.8%) | 1.000 |
AUR | 5 (7.6%) | 2 (25.0%) | 0.163 | 0 | 7 (10.3%) | 1.000 |
UTI | 9 (13.6%) | 2 (25.0%) | 0.339 | 0 | 11 (16.2%) | 0.583 |
PVR (% CBC) | 44.4 ± 23.0 | 43.8 ± 26.2 | 0.946 | 43.3 ± 17.8 | 44.4 ± 23.7 | 0.917 |
VE (% CBC) | 55.5 ± 23.2 | 56.3 ± 26.2 | 0.928 | 56.7 ± 17.8 | 55.4 ± 23.8 | 0.903 |
Duration (mean ± SD) | 6.80 ± 5.78 | 3.38 ± 2.50 | 0.103 | 7.33 ± 1.51 | 6.35 ± 5.84 | 0.685 |
Treatment Outcome | CVA (n = 26) | PD (n = 7) | Dementia (n = 12) | Total (n = 45) | p Value |
---|---|---|---|---|---|
Age | 68.9 ± 11.7 | 71.6 ± 11.8 | 70.7 ± 6.8 | 69.8 ± 10.5 | 0.793 |
Improved | 21 (80.8%) | 6 (85.7%) | 7 (58.3%) | 34 (75.6%) | 0.347 |
Failed | 5 (19.2%) | 1 (14.3%) | 5 (41.7%) | 11 (24.4%) | |
UUI | 6 (23.1%) | 3 (42.9%) | 2 (16.7%) | 11 (24.4%) | 0.489 |
Difficult urination | 3 (11.5%) | 2 (28.6%) | 10 (83.3%) | 15 (33.3%) | 0.000 |
AUR | 0 | 0 | 2 (16.7%) | 2(4.4%) | 0.088 |
UTI | 0 | 2 (28.6%) | 5(41.7%) | 7(15.6%) | 0.001 |
PVR (% CBC) | 32.5 ± 23.0 | 40.0 ± 27.7 | 55.4 ± 31.1 | 39.8 ± 27.3 | 0.052 |
VE (% CBC) | 67.5 ± 23.0 | 60.0 ± 27.7 | 44.5 ± 31.1 | 60.2 ± 27.3 | 0.052 |
Duration (mean ± SD) | 5.58 ± 4.71 | 10.3 ± 7.52 | 3.17 ± 3.10 | 5.67 ± 5.27 | 0.014 |
DO (n = 41) | DU (n = 4) | p Value | USD (n = 43) | Non-USD (n = 2) | p Value | |
---|---|---|---|---|---|---|
Improved (n = 34) | 33(80.5%) | 1 (25.0%) | 0.040 | 34(79.1%) | 0 | 0.056 |
Failed (n = 11) | 8 (19.5%) | 3 (75.0%) | 9(20.9%) | 2(100%) | ||
UUI | 11 (26.8%) | 0 | 0.558 | 11 (25.6%) | 0 | 1.000 |
Difficult uriantion | 15 (36.6%) | 0 | 0.285 | 13 (30.2%) | 2 (100%) | 0.106 |
AUR | 2 (4.9%) | 0 | 1.000 | 1 (2.3%) | 1 (50.0%) | 0.088 |
UTI | 7 (17.1%) | 0 | 1.000 | 6 (14.0%) | 1 (50.0%) | 0.290 |
PVR (% CBC) | 39.5 ± 28.0 | 42.5 ± 22.2 | 0.837 | 37.3 ± 25.3 | 92.5 ± 3.53 | 0.004 |
VE (% CBC) | 60.5 ± 28.0 | 57.5 ± 22.2 | 0.837 | 62.7 ± 25.3 | 7.50 ± 3.54 | 0.004 |
Duration (mean ± SD) | 5.93 ± 5.21 | 3.00 ± 6.00 | 0.295 | 5.93 ± 5.25 | 3.00 ± 6.00 | 0.121 |
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Jiang, Y.-H.; Jhang, J.-F.; Chen, S.-F.; Kuo, H.-C. Real-Life Treatment Outcome of Botulinum Toxin A Injection on Overactive Bladder and Voiding Dysfunction in Patients with Central Nervous System Lesions. Toxins 2024, 16, 123. https://doi.org/10.3390/toxins16030123
Jiang Y-H, Jhang J-F, Chen S-F, Kuo H-C. Real-Life Treatment Outcome of Botulinum Toxin A Injection on Overactive Bladder and Voiding Dysfunction in Patients with Central Nervous System Lesions. Toxins. 2024; 16(3):123. https://doi.org/10.3390/toxins16030123
Chicago/Turabian StyleJiang, Yuan-Hong, Jia-Fong Jhang, Sheng-Fu Chen, and Hann-Chorng Kuo. 2024. "Real-Life Treatment Outcome of Botulinum Toxin A Injection on Overactive Bladder and Voiding Dysfunction in Patients with Central Nervous System Lesions" Toxins 16, no. 3: 123. https://doi.org/10.3390/toxins16030123