Outcomes of intradetrusor onabotulinum toxin A injection in patients with Parkinson's disease

Gregory Vurture, Benoit Peyronnet, Andrew Feigin, Milton C. Biagioni, Rebecca Gilbert, Nirit Rosenblum, Steven Frucht, Alessandro Di Rocco, Victor W. Nitti, Benjamin M. Brucker

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objective: To assess the safety and efficacy of intradetrusor onabotulinum toxin A injections for the treatment of overactive bladder (OAB) in patients with Parkinson's disease (PD). Methods: All PD patients who underwent intradetrusor injections of onabotulinum toxin A (BoNT-A) for storage symptoms between 2010 and 2017 were included in a retrospective study. A 100 U dose of BoNT-A (Botox®, Allergan Irvine, CA) was used for the first injection in all patients. The primary endpoint was clinical success defined as any subjective improvement in OAB symptoms self-assessed by the patients 4 weeks after the injections. Results: Out of 24 patients analyzed, 19 reported improvement of their OAB symptoms 4 weeks after the first injection (79.2%) with complete resolution of urgency urinary incontinence in seven patients (29.1%; P < 0.001). The average post-void residual (PVR) increased significantly after the first injection from 17.6 to 125.3 mL (P < 0.001). Three of the patients had to start clean intermittent catheterization (CIC) after the first injection (12.5%). Out of 49 injections in total, only five caused incomplete bladder emptying requiring the use of CIC (10.2%). Higher pre-injection PVR was significantly associated with both a lower chance of symptomatic improvement (P = 0.04) and a higher risk of incomplete bladder emptying with institution of CIC (P = 0.047). Conclusion: Intradetrusor injections of BoNT-A 100 U appeared as a safe and effective option in PD patients with OAB symptoms and a low PVR before the injection. Higher preoperative PVR was the strongest predictor of both treatment failure and postoperative urinary retention requiring CIC.

Original languageEnglish
Pages (from-to)2669-2677
Number of pages9
JournalNeurourology and Urodynamics
Volume37
Issue number8
DOIs
StatePublished - Nov 2018
Externally publishedYes

Keywords

  • Parkinson's disease
  • botulinum toxin
  • injection
  • neurogenic detrusor overactivity
  • outcomes

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