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대한배뇨장애요실금학회 International Neurourology Journal International Neurourology Journal 제20권 제1호
발행연도
2016.1
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40 - 46 (7page)

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Purpose: To investigate the efficacy and safety of repeated botulinum toxin type-A (BTX-A) injections for patients with drugrefractory nonneurogenic overactive bladder (NNOAB) and explore factors predictive of outcome. Methods: Data were collected from all patients receiving repeated BTX-A injections for drug-refractory NNOAB between 2004 and 2012. Trigone-sparing injections were administered under sedation with antibiotic prophylaxis. Patient characteristics including age, sex, preoperative urodynamics, injection number, BTX-A dose, complications, and patient global impression of improvement (PGI-I) scores were collected. Correlations between patient factors and outcomes were assessed by using Pearson’s chi-square tests. Results: Fifty-two patients with a mean age of 67.4 years (range, 26–93 years) received 140 BTX-A injections in total; 33 (64%), 15 (29%), and 4 patients (7%) received 2, 3 to 4, and 5 to 8 injections, respectively. Mean follow-up time was 49 months (range, 9–101 months). Nine patients developed urinary tract infection; additionally, 3 patients experienced transient urinary retention. Median PGI-I score was 2 out of 7 (interquartile range [IQR], 2). For 46 patients, the PGI-I score remained stable with the administration of each injection. Pearson chi-square tests revealed that male patients or reduced bladder compliance was associated with a higher (worse) PGI-I score. Median PGI-I scores for men and women were 3 (IQR, 1) and 2 (IQR, 1), respectively; additionally, median PGI-I scores for those with normal bladder compliance and those with reduced bladder compliance were 2 (IQR, 2) and 4.5 (IQR, 1), respectively. Median PGI-I scores and complication rates were the same in the older patient (≥70 years) and younger (<70 years) patient cohorts. Conclusions: Efficacy is maintained with repeated BTX-A injections. Patients including the elderly show a good degree of tolerability with a low complication rate. Male patients or reduced bladder compliance is associated with poorer outcomes.
#Botulinum Toxins #Urinary Bladder #Overactive #Urodynamics #Treatment Outcome

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참고문헌 (26)

참고문헌 신청
Abrams P / 2002 / The standardisation of terminology of lower urinary tract function:report from the Standardisation Sub-committee of the International Continence Society / Neurourol Urodyn 21:167~178 google schola Chapple CR / 2008 / The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis / Eur Urol 54:543~562 google schola Brostrom S / 2009 / Persistence of antimuscarinic drug use / Eur J Clin Pharmacol 65:309~314 google schola Gormley EA / 2012 / Diagnosis and treatment of overactive bladder (non-neurogenic)in adults: AUA/SUFU guideline / J Urol 188(6 Suppl):2455~2463 google schola Allahdin S / 2012 / An overview of treatment of overactive bladder syndrome in women / J Obstet Gynaecol 32:217~221 google schola

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