Botulinum injections for the treatment of bladder symptoms of multiple sclerosis.

Abstract

OBJECTIVE:

Our objective was to demonstrate the efficacy and impact on quality of life of detrusor injections of botulinum neurotoxin type A in the treatment of bladder dysfunction in patients with multiple sclerosis.

METHODS:

Forty-three patients with multiple sclerosis suffering from severe urgency incontinence were treated with detrusor injections of botulinum neurotoxin type A. Data from cystometric assessment of the bladder, voiding diaries, quality-of-life questionnaires, and procontinence medication usage were collected before treatment and 4 and 16 weeks after injection. The same data were also collected after repeat treatments.

RESULTS:

Highly significant improvements (p < 0.0001) in incontinence episodes and urinary urgency, daytime frequency and nocturia, were the symptomatic reflection of the significant improvements in urodynamically demonstrated bladder function. Although 98% of patients had to perform self-catheterization after treatment, there were sustained improvements in all quality-of-life scores. The mean duration of effect was 9.7 months. Similar results were seen with repeat treatments.

INTERPRETATION:

Minimally invasive injections of botulinum neurotoxin type A have been shown to be exceptionally effective in producing a prolonged improvement in urinary continence in patients with multiple sclerosis. This treatment is likely to have a major impact on future management.

• Authors: Vinay Kalsi, Gwen Gonzales, Roshni Popat, Apostolos Apostolidis, Sohier Elneil, Prokar Dasgupta, Clare J Fowler
• Journal: Annals of neurology (Ann Neurol) Vol. 62 Issue 5 Pg. 452-7 (Nov 2007) ISSN: 1531-8249 [Electronic] United States
• PMID: 17890635 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Botulinum Toxins, Type A

Topics

• Administration, Intravesical
• Adult
• Animals
• Botulinum Toxins, Type A (administration & dosage)
• Female
• Humans
• Injections, Intramuscular
• Male
• Mice
• Middle Aged
• Multiple Sclerosis (complications, drug therapy, physiopathology)
• Prospective Studies
• Treatment Outcome
• Urinary Incontinence (drug therapy, etiology, physiopathology)