Clinical effectiveness of intradetrusor injections of botulinum toxin type a in dose 100 units in multiple sclerosis patients with neurogenic detrusor overactivity
- Authors: Filippova Е.S.1,2, Bazhenov I.V.1,2, Zyrjanov A.V.1,2, Zhuravlev V.N.1, Borzunov I.V.1, Ustinov G.S.1
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Affiliations:
- Urals State Medical University of the Ministry of Healthcare of the Russian Federation
- Sverdlovsk Regional Clinical Hospital No. 1
- Issue: Vol 10, No 1 (2020)
- Pages: 25-32
- Section: Original articles
- URL: https://journals.rcsi.science/uroved/article/view/17899
- DOI: https://doi.org/10.17816/uroved10125-32
- ID: 17899
Cite item
Abstract
Intravesical injections of botunulinum toxin type A (BTA) demonstrate good results in treatment of detrusor overactivity symptoms in patients with neurogenic low urinary tract dysfunction (NLUTD) when use in recommended doses of 200 and 300 Units. In clinical practice a government insurance dose not cover the price for the 200 BTA Units and only 100 Units may be injected in patients with neurogenic and nonneurogenic detrusor overactivity.
The aim was to evaluate the efficiency of intradetrusor injections of BTA in patients with NLUTD.
Materials and methods. The study included 28 MS patients with resistant to medical treatment neurogenic detrusor overactivity. All patients received intradetrusor injections of 100 BTA Units. The results were assessed after 1, 3 and 6 months after procedure.
Results. Clinical improvement had been achieved in all 28 patients. According to the urodynamic studies three months after BTA injections maximal cystometric capacity increased by 119.9 ± 37.6% (p < 0,05), volume at first detrusor involuntary contraction increased by 74.8 ± 21.4% (p < 0,05), maximal detrusor pressure at involuntary contraction decreased by 53.5 ± 29.7% (p < 0,05). The NBSS total score decreased from 38.04 ± 14.27 to 29.06 ± 14.46 (p = 0,000), mainly because of questions about incontinence and urgency. SF-Qualiveen total score turned from 2.32 ± 0.70 to 1.61 ± 0.85 (p = 0.000). Before procedure 2 patients performed intermittent catheterization, 4 patients catheterized after BTA injections.
Conclusion. Intradetrusor injection of 100 BTA Units in MS patients with NLUTD resulted in improvement of urodynamic parameters followed by reduction of clinical symptoms and life quality improvement for 6 months of observation. Using of BTA low dose didn’t provide a total abortion of neurogenic detrusor overactivity symptoms but led to the starting of IC only in 2 patients.
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##article.viewOnOriginalSite##About the authors
Еkaterina S. Filippova
Urals State Medical University of the Ministry of Healthcare of the Russian Federation; Sverdlovsk Regional Clinical Hospital No. 1
Author for correspondence.
Email: filippova.cat@yandex.ru
ORCID iD: 0000-0003-3065-3953
SPIN-code: 6364-8190
Candidate of Medical Sciences, Associate Professor of the Department of Urology; Urologist
Russian Federation, EkaterinburgIgor V. Bazhenov
Urals State Medical University of the Ministry of Healthcare of the Russian Federation; Sverdlovsk Regional Clinical Hospital No. 1
Email: biv@okb1.ru
ORCID iD: 0000-0003-1745-700X
SPIN-code: 7269-7282
Doctor of Medical Sciences, Professor of the Department of Urology; Head of the Urological Unit
Russian Federation, EkaterinburgAleksandr V. Zyrjanov
Urals State Medical University of the Ministry of Healthcare of the Russian Federation; Sverdlovsk Regional Clinical Hospital No. 1
Email: zav1965@mail.ru
ORCID iD: 0000-0001-8105-7233
SPIN-code: 6193-4204
Doctor of Medical Sciences, Professor. Chairman of the Department of Urology; Head of the Regional Urological Center of the Sverdlovsk Regional Clinical Hospital No. 1
Russian Federation, EkaterinburgVladimir N. Zhuravlev
Urals State Medical University of the Ministry of Healthcare of the Russian Federation
Email: zhuravlev@okb1.ru
SPIN-code: 7045-1956
Doctor of Medical Sciences, Professor
Russian Federation, EkaterinburgIgor V. Borzunov
Urals State Medical University of the Ministry of Healthcare of the Russian Federation
Email: ivborzunov@e1.ru
ORCID iD: 0000-0002-9827-8451
SPIN-code: 5502-4009
Doctor of Medical Sciences, Professor of the Department of Urology
Russian Federation, EkaterinburgGennadiy S. Ustinov
Urals State Medical University of the Ministry of Healthcare of the Russian Federation
Email: GennadiyUstinov@mail.ru
ORCID iD: 0000-0002-4263-4568
SPIN-code: 8423-8060
Student
Russian Federation, EkaterinburgReferences
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