Research: BoTox for Bladder problems

Deffontaines-Rufin S et al. Botulinum Toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients. Int Braz J Urol 2011 Sep;37:642-8

Purpose:
Neurogenic detrusor overactivity (NDO. The muscle controlling bladder contraction is over active = urinary incontinence) is common in patients who suffer from multiple sclerosis (MS). When the usual pharmacological treatment fails, botulinum toxin type A (BTX-A=Botox) injections can be proposed. The safety and efficacy of this treatment are already well known, but only a few studies focus on its use in patients with MS.

Materials and Methods: Seventy-one patients with MS underwent their first BTX-A injection for refractory (doesn't respond to therapy) NDO. They had bladder function assessed before and three months after injection. The patients were divided in three groups according to treatment efficacy: full success (total urinary continence, no overactive detrusor), improvement, or total failure (urge incontinence and overactive detrusor = when you've gotta, you've gotta go).

BoTox Injection Sites

Results: 77% of the patients had clinical improvement or full success of the treatment with a reduction of their urgency and incontinence. Significant urodynamic improvement after treatment was shown on different parameters: volume at first involuntary bladder contraction (p = 0.0000001), maximum vladder capacity (p = 0.0035), maximum detrusor pressure (p = 0.0000001). 46% of the patients were in the ″ full success ″ group. 31% of the patients had a partial improvement. 23% of the patients had no efficacy of the treatment. Duration of MS was a predictive factor of treatment failure (p = 0.015).

Conclusions: Despite that a full success was obtained in 46% of the cases, BTX-A injection therapy failed to treat refractory NDO in 23% of patients suffering from MS. Duration of the disease was a predictive factor for an inefficient treatment. The injection therapy should be considered as soon as oral anti-cholinergic (inhibit acetyl choline that is a nerve transmitter chemical) drugs fail to reduce NDO.

More confirmatory evidence for the value of Botox...its not just about fixing foreheads but it can be a valuble medicine. Please leave a look at previous posts

01 Aug 2011
Objective:To assess the effects of onabotulinumtoxinA (BOTOX(®), Allergan, Inc.) on urinary incontinence in people with detrusor bladder problems. Trial: This multicentre, randomised, double-blind, placebo-controlled study .

Multiple Sclerosis Research: Efficacy of Botulinum Toxin A Injection ...
20 Apr 2011
Efficacy of Botulinum Toxin A Injection for Neurogenic Detrusor Overactivity and Urinary Incontinence: A Randomized, Double-Blind Trial. Herschorn et al. J Urol. 2011 Apr 15. [Epub ahead of print] "Confirmation that Botox ...



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