Intradetrusor injection of botulinum toxin type A is an effective minimally invasive option for patients with pharmacologically refractory idiopathic detrusor overactivity (IDO) and its dosage is currently under evaluation.
The aim of this study was To assess the efficacy of intradetrusor injection of botulinum toxin type A 100 u versus 200 u for the treatment of overactive bladder.
Between May 2011 toseptember 2013, the study was conducted on 80 patients with idiopathic overactive bladder (IOAB) after a patients' consent and agreement of ethical committee of Banha faculty of medicine then randomly classified into 2 groups A and B. Group A underwent Intradetrusor Injection Of Botulinum Toxin Type A 100 Units and group B underwent Intradetrusor Injection Of Botulinum Toxin Type A 200 Unit . Overactive bladder symptom score (OABSS) was adjusted on all patients preoperative and postoperative at 1,3,6,9 monthes also Urodynamics were done for all patients preoperative and postoperative at 3,6,9 monthes .
It had been found that Intradetrusor injection of botulinum toxin type A is an effective treatment for patients with refractory IDO. According to OABSS and urodynamic finding ,there is no significant difference in the results between the two groups in 1,3,6 monthes but during the ninth month follow up ,the good results still preserved in group B but significantly decreased in group A. Dysuria and high postvoiding residual urine incidence is higher in group B as the adverse events was dose dependent.
Conclusion:
A single-injection procedure of 100 U or 200 U BoNTA is an effective and safe treatment for patients with iOAB who failed anticholinergic regimens. Following the procedure, OABSS and QoL were improved for 6 mo; 100 U injections seemed to have a comparable results with 200 U. at month 9 there was a significant difference towards 200 U with more incidence of adverse events.
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