PARIS, FRANCE (UroToday.com) - Botulinumtoxin A has proven efficacy in patients with BO of neurogenic as well as idiopathic origin refractory for antimuscarinics.
However, it is only approved in patients with neurogenic bladder dysfunction. We present our 9 year single-centre experience with off-label detrusor injections for neurogenic and non-neurogenic BO.
Starting in 07/2001, 92 patients with cystometrically confirmed idiopathic detrusor overactivity (IDO) and 78 patients with neurogenic detrusor overactivity (NDO) refractory for standard treatment were injected with 300 U Botulinumtoxin A into the detrusor (10 U per 1 ml injection). Between 02/2006 and 04/2008, patients were randomized in a double-blind fashion into two groups receiving equal doses of either Xeomin (Merz Inc.) or Botox (Allergan Inc.). Prior to and 6 weeks after injection, voiding diaries and cystometry were performed and patient satisfaction was evaluated. Statistical analysis included student´s t-test and Fisher´s exact test.
Frequency and cystometric bladder capacity improved significantly, whereas post-void residual increased (not significantly in the IDO patients). There was no statistical significant difference between the Botox and the Xeomin group. However, satisfaction rates were significantly higher in the Xeomin group.
Although the objective treatment results were equal in both groups, patients receiving Xeomin tend to be more satisfied. This can be explained by the negative patient selection of the early treatment period between 2001 and 2006 but needs further confirmatory efforts.
Presented by Hampel C,1 D'Andrea D,1 Gillitzer R,2 Thüroff JW,1 and Roos F1 at the 27th Annual European Association of Urology (EAU) Congress - February 24 - 28, 2012 - Le Palais des Congrès de Paris, Paris, France
1University Medical Center, Johannes Gutenberg University, Dept. of Urology, Mainz, Germany, 2Klinikum Darmstadt, Dept. of Urology, Darmstadt, Germany