Intravesical OnabotulinumtoxinA Injection for Overactive Orthotopic Ileal Neobladder: Feasibility and Efficacy

The efficacy of intravesical onabotulinumtoxinA (BTXA) in the treatment of overactive bladder (OAB) has been well documented. The use of BTXA injection in orthotopic neobladders is yet to be studied. We present 4 cases of patients injected with intravesical BTXA for overactive orthotopic ileal neobladder. We recorded patient demographics, presenting and follow-up symptoms, urodynamic profiles, and Patient Global Impression of Improvement (PGI-I) scores. The 4 patients reported varying degrees of subjective improvements in the symptoms, including urgency, urge incontinence, and pad usage. Mean follow-up duration was 8.3 months (range, 5-14 months). Average PGI-I score was 3 ("a little better") (range, 2-4). To our knowledge, the current study is the first case series examining BTXA injection for orthotopic neobladder overactivity. BTXA injection yielded varying degrees of objective and subjective improvements, without significant complications. Intravesical BTXA injection is feasible and may be considered as a potential treatment alternative for OAB in orthotopic neobladders, although further study is warranted.

International neurourology journal. 2016 Mar 07 [Epub]

Nathan Hoag, Vincent Tse, Audrey Wang, Eric Chung, Johan Gani

Department of Urology, Austin Hospital, University of Melbourne, Melbourne, Australia., Department of Urology, Concord Repatriation General Hospital, University of Sydney, Sydney, Australia., Department of Urology, Westmead Hospital, Macquarie University, Sydney, Australia., Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia., Department of Urology, Austin Hospital, University of Melbourne, Melbourne, Australia.

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