Botulinum Toxin Type A in Patients With Parkinson's Disease and Refractory Overactive Bladder

Giannantoni, Antonella; Conte, Antonella; Proietti, Silvia; Giovannozzi, Silvia; Rossi, Aroldo; Fabbrini, Giovanni; Porena, Massimo; Berardelli, Alfredo

doi:10.1016/j.juro.2011.04.071

Cited by 91 publications

(66 citation statements)

References 23 publications

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“…In line with previous studies [14, 15, 21, 22], we found in PD patients a significant improvement in urodynamic-, bladder diary parameters and consequently in the ICIQ score after 200 IU OnabotA injection with preserved micturition. The mean age of our patients was representative of the PD population.…”

Section: Discussionsupporting

confidence: 93%

“…Due to different study protocols used, the comparison of results from recent studies [14, 15, 21, 22] with our data is difficult. However, most parameters at the follow-up visits provided global improvement in urodynamic-and/or bladder diary parameters.…”

Section: Discussionmentioning

confidence: 75%

“…The application of OnabotA injection in patients with NLUTD was pioneered by Schurch and colleagues [22]. After OnabotA injection (200 of 300 IU, Botox®, Allergan) in patients with spinal cord injury urodynamic-as well as bladder diary parameters improved significantly [23].…”

Section: Discussionmentioning

confidence: 99%

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Preserved micturition after intradetrusor onabotulinumtoxinA injection for treatment of neurogenic bladder dysfunction in Parkinson’s disease

et al. 2016

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BackgroundTo assess the efficacy and safety of intradetrusor onabotulinumtoxinA (OnabotA) injection treatment in patients with neurogenic lower urinary tract dysfunction (NLUTD), especially for patients with Parkinson disease (PD).MethodsPD patients refractory to oral antimuscarinic participated in an off-label use study and were evaluated prior and after 200 IU OnabotA injection into detrusor muscle, including trigone. Changes due to treatment were evaluated using bladder diaries, urodynamics, and questionnaires. Statistical analysis comprised Wilcoxon rank-sum test. Values are presented as mean ± standard deviation.ResultsTen PD patients (4 female and 6 male, mean age: 67.9 ± 5.36 years) with LUTD were enrolled. All patients tolerated the treatment. Bladder diary variables decreased significantly (p ≤ 0.011) after OnabotA injection compared to variables prior injection. Desire to void and maximum bladder capacity increased significantly in urodynamics (p ≤ 0.05). Maximum detrusor pressure during voiding phase normalised from 56.2 to 18.75 cm/H20. Detrusor overactivity was less often detectable. All patients voided spontaneously. Mean post void residual (PVR) volume was 77.0 ± 119.78 mL postoperatively. No urinary retention or side effects have been observed during/after treatment. Mean follow-up time was 4 months (range of 1–12). 4 patients requested repeated injection after a mean period of 10 months between first and second injection.ConclusionsOur data confirm the efficacy and safety of 200 IU OnabotA injection in patients with neurogenic LUTD due to PD. The risk of urinary retention or high post-urinary residual volumes seems to be minor after OnabotA-injection. More research is needed with larger sample size to confirm the significance of these findings.Trial registrationTrial Number: ISRCTN 11857462, Registration Date 2016/10/08

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 75%

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Preserved micturition after intradetrusor onabotulinumtoxinA injection for treatment of neurogenic bladder dysfunction in Parkinson’s disease

et al. 2016

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“…The follow-up assessment extends our previous findings at three months (Giannantoni et al, 2009) by showing that the BoNT/A-induced clinical and urodynamic improvement lasts at least six months (Giannantoni et al, 2011). We also noted that clinical and urodynamic amelioration was similar when comparing patients treated with 100 UI of BoNT/A with those treated with 200 UI.…”

Section: Discussionsupporting

confidence: 84%

Botulinum A Toxin Intravesical Injections in the Treatment of Refractory Overactive Bladder in Patients with Parkinson's Disease

Giannantoni¹,

Proietti²,

Conte³

et al. 2011

Towards New Therapies for Parkinson's Disease

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“…96 For patients with Parkinson disease and OAB that is refractory to antimuscarinic treatment, detrusor injec tions of 100 units of BoNTA have been reported to induce clinical and urodynamic improvements that last for more than 6 months after treatment. 97,98 One study, in which 20 patients with Parkinson disease received 100unit injections of BoNTA into the bladder, includ ing the trigone, confirmed the therapeutic results of this procedure; furthermore, no patients developed any notable urinary retention up to 6 months after receiv ing this treatment. 99 By contrast, patients with chronic NDO owing to a cerebrovascular accident did not have similar responses to treatment.…”

Section: Ndo Owing To Neuropathiesmentioning

confidence: 82%

Current and potential urological applications of botulinum toxin A

Jiang

Liao

2015

Nat Rev Urol

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Botulinum toxin subtype A (BoNT-A) is a potent neurotoxin that can selectively modulate neurotransmitter release from nerve endings, resulting in muscular paralysis. BoNT-A might also act on sensory nerves, and have an anti-inflammatory effect. In the first urological use of BoNT-A, injection into the urethral sphincters of patients with detrusor-sphincter dyssynergia resulted in a reduction of urethral resistance and improved voiding efficiency. Subsequently, intravesical BoNT-A injections have received regulatory approval for treatment of neurogenic detrusor overactivity owing to spinal cord lesions or multiple sclerosis, and idiopathic overactive bladder in adults. BoNT-A has also been widely used to treat patients with the off-label indications of neurogenic or non-neurogenic voiding dysfunction and male lower urinary tract symptoms owing to BPH and bladder-neck dysfunction. Other indications for which urologists have applied BoNT-A injections include interstitial cystitis/bladder pain syndrome, bladder oversensitivity and chronic pelvic pain syndrome. BoNT-A is currently delivered as an intravesical injection; however, use of liposome encapsulated formulations is also beginning to show some therapeutic potential.

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Botulinum Toxin Type A in Patients With Parkinson's Disease and Refractory Overactive Bladder

Abstract: Intradetrusor injection of 100 U botulinum toxin type A induced clinical and urodynamic improvement in overactive bladder symptoms that lasted at least 6 months in patients with Parkinson's disease.

Cited by 91 publications

References 23 publications

Preserved micturition after intradetrusor onabotulinumtoxinA injection for treatment of neurogenic bladder dysfunction in Parkinson’s disease

Preserved micturition after intradetrusor onabotulinumtoxinA injection for treatment of neurogenic bladder dysfunction in Parkinson’s disease

Botulinum A Toxin Intravesical Injections in the Treatment of Refractory Overactive Bladder in Patients with Parkinson's Disease

Current and potential urological applications of botulinum toxin A

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