Botulinum toxin (OnabotulinumtoxinA) in the male non-neurogenic overactive bladder: clinical and quality of life outcomes

OBJECTIVE: To assess the efficacy of OnabotulinumtoxinA (BTXA) injections in men with drug-refractory non-neurogenic overactive bladder (NNOAB).

PATIENTS AND METHODS: A total of 43 men received BTXA injections for NNOAB from 2004 to 2012. Patient Global Impression of Improvement (PGI-I) score was obtained. For men with wet NNOAB, change in number of pads per day was also assessed.

RESULTS: 43 men with a mean age of 69 (range 37-85) received at least one injection. Of the 43 men, 20 (47%) had prior prostate surgery: 11 had radical prostatectomy (RP) and 9 had transurethral resection of prostate (TURP). Overall, average PGI-I score was 2.7. Comparing PGI-I score in men who had prior prostate surgery with men who have not: 2.6±0.5 Vs 2.8±0.5 respectively (average ± 95%CI), p = 0.6. Comparing PGI-I score in men who had previous TURP with men who had previous RP: PGI-I score: 3.3±0.8 Vs 2.0±0.5 respectively, p < 0.05. Men who had RP experienced a reduction in pad use (from 3.5±1.7 to 1.6±0.9pads/day, p < 0.05) while this was not the case amongst men who had TURP (from 1.7±1.5 to 1.4±1.5 pads/day, p = 0.4).

CONCLUSIONS: Overall, BTXA injection in men with drug-refractory NNOAB does provide a symptomatic benefit. Amongst men who have had prior prostate surgery, men who have had RP experience a greater benefit than men who have had TURP, both in regards to PGI-I score and pad use. This article is protected by copyright. All rights reserved.

BJU Int. 2015 Jul 14. doi: 10.1111/bju.13110. [Epub ahead of print]

Habashy D 1, Losco G 1, Tse V 1,2, Collins R 1, Chan L 1,2.

1 Concord Repatriation General Hospital, Sydney, Australia.
2 University of Sydney, Australia.