Wirkung von Botulinumtoxin A in der ein- und mehrmaligen Behandlung der überaktiven Blase

Frohme, Carsten; Varga, Zoltán; Olbert, P.; Schrader, Andres Jan; Hofmann, Rainer; Hegele, Axel

doi:10.1007/s00120-009-2208-9

Cited by 15 publications

(1 citation statement)

References 14 publications

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“…Intravesical BoNT–A administration has been shown to be a safe and effective therapy for refractory idiopathic OAB. It is a reasonable treatment of patients impossible to take anticholinergic medication [15–17, 21, 22]. To date several studies tried to elucidate cause and mechanism of OAB, but it is still poorly understood [4, 18, 19, 23].…”

Section: Discussionmentioning

confidence: 99%

Changes in prostaglandin E2 in patients with idiopathic overactive bladder syndrome after botulinum toxin type A treatment: is there a clinical benefit?

et al. 2014

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BackgroundThe causality of overactive bladder syndrome (OAB) is still not fully understood. Several studies indicate a significant increase of prostaglandin E2 (PGE2) in patients with OAB. However, in order to clarify whether these compounds can help to objectify the clinical diagnosis, further studies are needed. This prospective study aims to analyze PGE2 blood levels (sPGE2) in patients with OAB before and after botulinum toxin type A (BoNT-A) therapy.MethodsBlood samples were obtained from 56 patients (52y, 18–87) with idiopathic OAB. sPGE2 levels were measured before and 4 weeks after BoNT-A treatment by enzyme linked immunosorbent assay (ELISA). 31 healthy persons with normal bladder function served as control group (59 y, 21–72). sPGE2 was set in relation to clinical data and the severity of OAB (wet/dry). The statistical data analysis was performed by using the non-parametric Mann–Whitney U test and paired t-test.ResultsSignificant higher sPGE2 levels were detected in patients with OAB compared to members of the control group (2750 pg/ml vs. 1674 pg/ml, p < 0.005). Furthermore sPGE2 levels were increased in patients with OAB wet compared to OAB dry (p <0.01). In 30 patients sPGE2 levels decreased significantly after BoNT-A treatment compared to baseline (2995 pg/ml vs. 1486 pg/ml, p <0.005). Patients reported an average drug effect of 9 month (0–19); incontinence pads were needed significantly less frequent (p < 0.05). 3 patients reported no postoperative effect. sPGE2 increased in two patients compared to initial levels, a single patient showed a remotely decreased sPGE2. Six patients were treated repeatedly with BoNT-A after showing an sPGE2 re-rise.ConclusionssPGE2-level is increased in patients with OAB. We could prove a significant decrease of sPGE2 after BoNT-A treatment. In this small cohort we could demonstrate a correlation between OAB and sPGE2, especially in the non-responder group. The use of sPGE2 as a biomarker in diagnostics and follow-up after therapy seems promising. To what extent sPGE2 can be useful as such needs to be examined prospectively in a larger population.

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