Friday, 25 November 2011

Research: BoTox for Bladder problems

Deffontaines-Rufin S et al. Botulinum Toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients. Int Braz J Urol 2011 Sep;37:642-8

Purpose:
Neurogenic detrusor overactivity (NDO. The muscle controlling bladder contraction is over active = urinary incontinence) is common in patients who suffer from multiple sclerosis (MS). When the usual pharmacological treatment fails, botulinum toxin type A (BTX-A=Botox) injections can be proposed. The safety and efficacy of this treatment are already well known, but only a few studies focus on its use in patients with MS.

Materials and Methods: Seventy-one patients with MS underwent their first BTX-A injection for refractory (doesn't respond to therapy) NDO. They had bladder function assessed before and three months after injection. The patients were divided in three groups according to treatment efficacy: full success (total urinary continence, no overactive detrusor), improvement, or total failure (urge incontinence and overactive detrusor = when you've gotta, you've gotta go).

BoTox Injection Sites

Results: 77% of the patients had clinical improvement or full success of the treatment with a reduction of their urgency and incontinence. Significant urodynamic improvement after treatment was shown on different parameters: volume at first involuntary bladder contraction (p = 0.0000001), maximum vladder capacity (p = 0.0035), maximum detrusor pressure (p = 0.0000001). 46% of the patients were in the ″ full success ″ group. 31% of the patients had a partial improvement. 23% of the patients had no efficacy of the treatment. Duration of MS was a predictive factor of treatment failure (p = 0.015).

Conclusions: Despite that a full success was obtained in 46% of the cases, BTX-A injection therapy failed to treat refractory NDO in 23% of patients suffering from MS. Duration of the disease was a predictive factor for an inefficient treatment. The injection therapy should be considered as soon as oral anti-cholinergic (inhibit acetyl choline that is a nerve transmitter chemical) drugs fail to reduce NDO.

More confirmatory evidence for the value of Botox...its not just about fixing foreheads but it can be a valuble medicine. Please leave a look at previous posts

01 Aug 2011
Objective:To assess the effects of onabotulinumtoxinA (BOTOX(®), Allergan, Inc.) on urinary incontinence in people with detrusor bladder problems. Trial: This multicentre, randomised, double-blind, placebo-controlled study .

20 Apr 2011
Efficacy of Botulinum Toxin A Injection for Neurogenic Detrusor Overactivity and Urinary Incontinence: A Randomized, Double-Blind Trial. Herschorn et al. J Urol. 2011 Apr 15. [Epub ahead of print] "Confirmation that Botox ...



4 comments:

  1. This comment has been removed by a blog administrator.

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  2. Julia Said

    77% is a great percentage, especially because we talk about a very ugly affection that bothers many of us.

    Then advert advert advert

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  3. OK that is really good news but when is it going to be available for us mere mortals to improve the quality of our lives.

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  4. Re: "OK that is really good news but when is it going to be available for us mere mortals to improve the quality of our lives."

    It has been available under the NHS for several years; quite a few of our patients have been treated already.

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