Intravesical injection of onabotulinumtoxinA in neurogenic overactive bladder patients with human T-cell leukemia virus type 1-associated myelopathy: A single-institution case series.

Neurogenic overactive bladder is a main feature of human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis. We successfully performed intravesical onabotulinumtoxinA therapy for refractory neurogenic overactive bladder due to human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis.

We retrospectively reviewed four neurogenic overactive bladder patients with human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis who underwent bladder wall injections of onabotulinumtoxinA from April to October 2020. All patients were female. Their median age was 66 (range, 63-71) years. They were previously treated with β3-adrenergic receptor agonists or anticholinergic drugs alone or in combination for ≥12 weeks. However, insufficient results were obtained. After 4 weeks of intravesical onabotulinumtoxinA therapy, overactive bladder symptoms improved and maximum cystometric capacity increased in all cases.

Intravesical onabotulinumtoxinA therapy may be useful for treating refractory overactive bladder due to human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis.

IJU case reports. 2021 May 05*** epublish ***

Tomohiro Matsuo, Tatsufumi Nakamura, Katsuya Sato, Yasuyoshi Miyata, Hideki Sakai

Department of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan., Department of Social Work Faculty of Human and Social Studies Nagasaki International University Sasebo Japan., Department of Locomotive Rehabilitation Science Unit of Rehabilitation Sciences Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.