Effects of onabotulinumtoxinA on cardiac function following intradetrusor injections

Mehnert, Ulrich; Kort, Laetitia Heck-de; Wöllner, Jens; Kozomara, Marko; Koeveringe, Gommert van; Kessler, Thomas M.

doi:10.1016/j.expneurol.2016.06.022

Cited by 7 publications

(8 citation statements)

References 30 publications

(66 reference statements)

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“…Additionally, no patients showed postoperative need for ISC. This is consistent with the data in the literature ( 24 , 25 ). Miotla et al ( 25 ) described a higher likelihood of postvoid residual volume of more than 200 ml or a need for ISC, but only among elderly patients with a higher rate of pregnancies and vaginal deliveries.…”

Section: Discussionsupporting

confidence: 94%

Quo Vadis Botulinum Toxin: Normative Constraints and Quality of Life for Patients With Idiopathic OAB?

et al. 2018

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Background: Idiopathic overactive bladder (iOAB), with or without urge incontinence (UI), has significant psychosocial effects on patients' quality of life (QoL). The first choice of treatment for iOAB is anticholinergics and, alternatively, the β-3-adrenoceptor agonist mirabegron. However, systemic side effects and contraindications should be considered for both medications.Objective: We report the efficacy, safety and effects on QoL of botulinum toxin therapy (onabotulinum toxin type A, BOTOX®, Allergan) among patients with iOAB ± UI.Patients and Methods: Between 2005 and 2013, 51 patients were treated with onabotulinum toxin A (100 units). The inclusion criteria were the presence of confirmed iOAB ± UI with previous use of anticholinergic medication. Micturition frequency, pad count, postvoid residual volume and QoL were evaluated using two validated questionnaires [the Client Satisfaction Questionnaire-8 (CSQ-8) and the King's Health Questionnaire (KHQ)]. Statistical analysis was performed with SPSS 24.0 (p < 0.05).Results: After botulinum toxin injection, a significant improvement in iOAB ± UI symptoms was observed. The micturition frequency decreased from 10.4 ± 0.5 to 5.2 ± 0.4 micturitions per day (p = 0.026), and the pad count decreased from 3.6 ± 1.0 to 1.2 ± 0.3 pads per day (p = 0.033). Anticholinergics were not used during the administration of botulinum toxin therapy. Complications and postoperative need for intermittent self-catheterization (ISC) were not observed. Overall, 72 and 24% of patients reported being “satisfied” or “very satisfied” with the treatment. Additionally, 66% of patients would choose botulinum toxin again for the treatment of iOAB.Conclusion: Botulinum toxin therapy is an efficient, safe, and life-improving treatment for iOAB.

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Section: Discussionsupporting

confidence: 94%

Quo Vadis Botulinum Toxin: Normative Constraints and Quality of Life for Patients With Idiopathic OAB?

et al. 2018

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“…We can speculate that this issue could be incidental or that it is associated with certain psychological factors. A lack of the systemic influence of intradetrusor onabotulinumtoxinA injections on heart function is consistent with previously published research conducted in patients suffering from a neurogenic bladder [ 18 ].…”

Section: Discussionsupporting

confidence: 91%

“…The study showed no effect on the resting state function of the heart, though it had some limitations. One was the lack of patients with cardiac disorders who might be more sensitive towards developing some potential abnormalities in electrocardiograms after treatment [ 18 ]. Therefore, it would be attractive to investigate the influence of onabotulinumtoxinA injections on heart function in patients with pre-existing cardiac arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

Can Intradetrusor OnabotulinumtoxinA Injections Alter Heart Function in Patients with Cardiac Arrhythmia?

Miotła

Olejniczak

Futyma

et al. 2018

JCM

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The prevalence of overactive bladder (OAB) increases with age and can be associated with other co-morbidities, such as cardiac arrhythmia. Unfortunately, commonly used anticholinergic drugs for OAB can affect the cardiovascular system, leading to tachycardia. However, there are no data, which consider the influence of intradetrusor onabotulinumtoxinA injections on heart function in idiopathic OAB patients. The aim of the present study was to evaluate the influence of intradetrusor onabotulinumtoxinA injections on electrocardiogram (ECG) parameters. Additionally, changes in ECG were analyzed in OAB patients without cardiac arrhythmia. Thirty-one patients with cardiac arrhythmia and 31 participants without irregular heart rate (HR) completed the study. ECG measurements were performed in supine positions 2 h before onabotulinumtoxinA injections, 1 h after treatment, and at 2 weeks of follow-up. At week 6, a phone-call survey was conducted to collect data about adverse events. OnabotulinumtoxinA injections were performed with rigid cystoscopy under local anesthesia. We did not observe any clinically significant changes in the analyzed ECG parameters between consecutive measurements. While a slight increase of HR was observed in patients without cardiac arrhythmia, it remained within normal range. Intravesical onabotulinumtoxinA injections are, hence, safe for female patients with cardiac arrhythmia and do not significantly influence changes in ECG.

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“…[35,36] Out of the numerous side effects of BTX injections described in literature in our group of patients we noted no serious adverse events. [37][38][39][40][41][42] For several years, Botulinum toxin has been successfully used in neuromuscular diseases with excessive muscular tension. It used to be administrated to muscles of extremities in children with spastic forms of infantile cerebral palsy.…”

Section: Resultsmentioning

confidence: 99%

“…So in our study, in children, respectively 10-30 units/kg body weight abobotulinum or 2,5-10 units /kg body weight of onabotulinum were used. [33][34][35][36][37][40][41][42][43][44][45][46][47][48][49][50] Estimating the optimal dosage both in children and adolescents is still discussed. Some authors show, both for abobotulinum or onabotulinum, no clear dose-related effect with the observation indicating that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo.…”

Section: Resultsmentioning

confidence: 99%

The endoscopic Botulinum toxin-A injections in equally efficient in the treatment of neurogenic bladder dysfunctions in children in different age groups. Single centre experience after more than 550 procedures.

Kroll¹,

Gajewska²,

Kasprowicz³

et al. 2018

Preprint

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The aim of this study was to evaluate the usefulness of cystoscopic injection of Botulinum-A toxin (BTX) in the detrusor wall in the treatment of children with decreased bladder capacity due to neurogenic bladder. The prospective, randomized non placebo controlled trial is conducted in our institution since year 2006 with the approval of the local Ethics Committee. 556 cystoscopic injections of BTX were performed in 141 children with neurogenic bladder in age 1 to 18 years. In all cases decreased bladder capacity and bladder overactivity with urine incontinence were estimated. The pre-and post-treatment evaluations included determination of urinary continence status, bladder function in frequency/volume chart of catheterized urine and in urodynamic studies. Parameters measured in urodynamic investigations included maximal cystometric capacity, detrusor reflex volume, maximal detrusor pressure. Parameters were analyzed before the cystoscopy and during the follow-up examinations in 5 age groups. Values of all measured parameters improved significantly and equally after therapy in every from 5 age groups. The results obtained from the study confirmed that endoscopic administration of BTX improves function of urinary bladder in children with neurogenic bladder, and the method represents an alternative approach to conservative treatment and surgical augmentation.

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Effects of onabotulinumtoxinA on cardiac function following intradetrusor injections

Cited by 7 publications

References 30 publications

Quo Vadis Botulinum Toxin: Normative Constraints and Quality of Life for Patients With Idiopathic OAB?

Quo Vadis Botulinum Toxin: Normative Constraints and Quality of Life for Patients With Idiopathic OAB?

Can Intradetrusor OnabotulinumtoxinA Injections Alter Heart Function in Patients with Cardiac Arrhythmia?

The endoscopic Botulinum toxin-A injections in equally efficient in the treatment of neurogenic bladder dysfunctions in children in different age groups. Single centre experience after more than 550 procedures.

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