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Actas Urol Esp. 2017 Feb 10. pii: S0210-4806(17)30007-4. doi: 10.1016/j.acuro.2017.01.003. [Epub ahead of print]

OnabotulinumtoxinA in urinary incontinence: Prospective Study of a Case Series.

[Article in English, Spanish]

Author information

1
Departamento de Obstetricia y Ginecología, Complejo Hospitalario Universitario Insular Materno-Infantil Las Palmas de Gran Canaria, Las Palmas, España. Electronic address: aliciammartinez@gmail.com.
2
Departamento de Obstetricia y Ginecología, Complejo Hospitalario Universitario Insular Materno-Infantil Las Palmas de Gran Canaria, Las Palmas, España.

Abstract

OBJECTIVE:

To assess the safety and efficacy of a single intravesical injection of onabotulinumtoxinA (OnaBTA) for treating urge urinary incontinence (UUI) in women.

METHOD:

We performed a prospective case-series study of consecutive patients with refractory UUI treated with an intravesical injection of OnaBTA. The patients were administered 100 units of OnaBTA injected into the bladder wall following 4 weeks of flushing with anticholinergic agents or beta 3 agonists. The urodynamic and clinical endpoints were evaluated before and 6 months after the injection of OnaBTA. The primary study endpoint was the number of episodes of urinary leakage.

RESULTS:

A total of 204 of the 210 selected patients conducted a valid visit 6 months after the therapeutic application. At 6 months of treatment with OnaBTA, 110 (53.9%) patients remained continent and were considered a success. However, 57 (27.9%) patients experienced one episode of urinary leakage per day, and 37 (18.2%) had 2 or more. In terms of the urodynamic parameters, we observed the following changes: increase in maximum bladder capacity (P<.0001) and reduced maximum pressure of the detrusor (P<.0001). In terms of the safety profile, 8 (3.9%) patients had self-limiting haematuria during the procedure, which resolved spontaneously, and 9 (4.4%) patients had acute urinary retention that required intermittent catheterisation.

CONCLUSIONS:

This study supports the use of OnabotulinumtoxinA in patients with urge urinary incontinence that does not respond to medical treatment.

KEYWORDS:

Botulinum toxin; Escapes de orina; Incontinencia urinaria; Sandvik severity index; Toxina botulínica; Urinary incontinence; Urine leakage; Índice de gravedad de Sandvik

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