Document Detail


Botulinum injections for the treatment of bladder symptoms of multiple sclerosis.
MedLine Citation:
PMID:  17890635     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of neurology     Volume:  62     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2007-12-27     Revised Date:  2011-10-17    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  452-7     Citation Subset:  IM    
Affiliation:
Institute of Neurology and Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
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
Grant Support
ID/Acronym/Agency:
799//Multiple Sclerosis Society
Chemical
Reg. No./Substance:
EC 3.4.24.69/Botulinum Toxins, Type A
Comments/Corrections
Comment In:
Nat Clin Pract Neurol. 2008 Apr;4(4):188-9   [PMID:  18285749 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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