Long‐term outcomes and risks factors for failure of intradetrusor onabotulinumtoxin A injections for the treatment of refractory neurogenic detrusor overactivity

Joussain, Charles; Popoff, M.; Phé, Véronique; Even, A.; Bosset, P.; Pottier, Sandra; Falcou, L.; Lévy, Jonathan; Vaugier, Isabelle; Chartier‐Kastler, Emmanuel; Schurch, Brigitte; Denys, Pierre

doi:10.1002/nau.23352

Cited by 33 publications

(26 citation statements)

References 27 publications

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“…(LE 3, GR C). 37 Nevertheless, the multivariate analysis failed to confirm it as an independent long-term risk factor.…”

Section: Maximum Detrusor Pressurementioning

confidence: 97%

“…A long-term study with a 7-year follow-up of neurogenic patients confirmed in a univariate analysis that decreased bladder compliance is a risk factor for therapy failure (LE 3, GR C). 37 Moreover, it has been reported that the efficacy of onabotulinumtoxinA injections in patients with low bladder compliance has a shorter duration (12-24 weeks) than in those with normal compliance. 40…”

Section: Bladder Compliancementioning

confidence: 99%

“…Joussain et al in their retrospective analysis of 292 patients, reported a failure rate of 12.6% (8.6-16.5%) after 3 years, 22.2% (16.6-27.3%) after 5 years and 28.9% (21.9-35.3%) after 7 years of follow-up, whereas the primary failure ratio was 5.1% (n = 15; LE 3, GR C). 37…”

Section: Repeated Injectionsmentioning

confidence: 99%

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How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

Przydacz¹,

Gołąbek²,

Chłosta³

2019

Adv Clin Exp Med

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Intra-detrusor injection therapy with onabotulinumtoxinA is generally accepted as a highly effective, minimally invasive and well-tolerated day procedure for patients with refractory overactive bladder (OAB) and neurogenic detrusor overactivity (NDO). The aim of this study was to summarize currently available methods of assessing treatment efficacy and risk factors that may influence the therapeutic effect of this approach. We found that there are discrepancies in the assessment methods. The evaluation of intra-detrusor injections with onabotulinumtoxinA in clinical trials are not always transposable into day-today practice. Moreover, the primary endpoints in clinical trials do not explore the entirety of meaningful patient-centered outcomes. Therefore, in daily clinical practice with patients with overactive bladder syndrome, the therapy should be assessed with objective measures (bladder diaries) and patient-oriented outcomes analyzing the quality of life (questionnaires). In neurogenic individuals, therapeutic efficacy should be additionally evaluated with urodynamic studies. Potential risk factors that may influence the treatment outcomes include urodynamically proven detrusor overactivity, elevated maximum detrusor pressure, greater maximum cystometric capacity, impaired bladder compliance, older age, male gender, a higher baseline bother score, previous anticholinergic treatment, and repeated injections with a subsequent decline in efficacy. The risk of intermittent catheterization following injections seems to depend on the etiology of detrusor overactivity, the injected dose, the injection technique, and the definition of significant post-void residual urine requiring catheterization.

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“…(LE 3, GR C). 37 Nevertheless, the multivariate analysis failed to confirm it as an independent long-term risk factor.…”

Section: Maximum Detrusor Pressurementioning

confidence: 97%

Section: Bladder Compliancementioning

confidence: 99%

See 1 more Smart Citation

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

Przydacz¹,

Gołąbek²,

Chłosta³

2019

Adv Clin Exp Med

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“…In the light of recent data discussed above, we believe there is a need to move towards a new era of managing intradetrusor botulinum toxin injections failures. Besides the options, nicely emphasized in the manuscript by Joussain et al, aiming to optimize BTX‐A intradetrusor injections in order to minimize the failure and discontinuation rates, we believe the aforementioned findings highlight the need to find and properly assess minimally invasive alternatives to augmentation cystoplasty to manage intradetrusor BTX‐A failures and withdrawals.…”

mentioning

confidence: 87%

Failures and long‐term discontinuations of intradetrusor botulinum toxin injections for neurogenic detrusor overactivity: A new challenge in neurourology

Peyronnet

Gamé

2017

Neurourology and Urodynamics

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“…In high risk patients with maximum detrusor pressure greater than 40 cm H 2 O, low bladder compliance, risk of autonomic dysreflexia, recurrent urinary tract infections, and recent changes in the upper urinary tract, it is probably advisable to undertake intradetrusor BTX-A injections under local anesthesia where possible. 6 Though, this would be dependent on local protocols and the changing situation in the country.…”

Section: Neurourology Patients Challenges In Covid-19 Outbreakmentioning

confidence: 99%

Technology‐based management of neurourology patients in the COVID‐19 pandemic: Is this the future? A report from the International Continence Society (ICS) institute

Hurі

Hamid

2020

Neurourology and Urodynamics

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Coronavirus disease‐2019 (COVID‐19) pandemic significantly altered our daily life as well as our professional practice. COVID‐19 has disrupted our lives both professionally and personally. We know the urological management in a neurogenic patient needs to be tailored to the individual circumstances, this is even more pertinent during these uncertain times. International Continence Society is the premier international organization in functional urology. Lately, it has established an institute to facilitate teaching and training opportunities all over the world. The School of Neurourology teamed with the School of Modern Technology and set up a Webinar—“How to manage the neuro‐urological patients in the current pandemic.” This was set up as a case‐based discussion to deliberate the management of our patients in the present climate and examine the role of modern technology in overcoming the current barriers.

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Long‐term outcomes and risks factors for failure of intradetrusor onabotulinumtoxin A injections for the treatment of refractory neurogenic detrusor overactivity

Abstract: This study confirms long-term efficacy and tolerance of Botox® injection in patients with NDO using CIC. Long-term failure and withdrawal rates remain low but significant, and need to be managed.

Cited by 33 publications

References 27 publications

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

Failures and long‐term discontinuations of intradetrusor botulinum toxin injections for neurogenic detrusor overactivity: A new challenge in neurourology

Technology‐based management of neurourology patients in the COVID‐19 pandemic: Is this the future? A report from the International Continence Society (ICS) institute

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