The effectiveness of intravesical Botox in idiopathic and non-idiopathic detrusor over activity

Soran Rafaat Ismail; Bahzad Koye

doi:10.15218/zjms.2011.0005

Authors

Soran Rafaat Ismail Neuro-Urology Department, Royal National Orthopa dic Hospital- Stanmore, UK
Bahzad Koye Urology Department, the James Cook University Hospital, UK

DOI:

https://doi.org/10.15218/zjms.2011.0005

Keywords:

Botox, Idiopathic detrusor over activity (IDO), Neuropathic detrusor over activity (NDO)

Abstract

Background and objectives: We have evaluated and compared the efficacy of Botox® in the treatment of bladder over activity in Idiopathic detrusor over activity (IDO) and Neuropathic detrusor over activity (NDO) in a tertiary centre. We hypothesised that the outcome of this less invasive treatment would be more promising in patients with IDO than those with NDO.

Methods: A total of 229 patients were reviewed with overactive bladder proven by urodynamic studies over the last 2 years. Of these, 174 patients received Botox® injection. 132 (75%) patients had IDO and 42 (25%) patients had NDO. 200 IU of Botox® was injected per patient in the IDO group and 300 IU in the neurogenic group.

Results: Eighty one of 118 (68.7%) known patients with IDO reported being dry after receiving the Botox® compared to 20/39 (51.3%) patients with NDO. Whereas, 88/118 (68.7%) patients with IDO reported significant satisfaction compared to 25/39 (64.1%) patients with NDO.

Conclusion: Botox® is an effective, minimally invasive treatment for drug refractory IDO + NDO. In comparison, patient reported satisfaction and dryness with the procedure was statistically the same. However, the IDO group responded slightly better to treatment. The average mean effect was the same in both groups.

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