European urology supplements vol:2 issue:1 pages:220-220
Aims of Study
Almost half of the patients with non neurogenic overactive bladder symptoms are resistent to
conservative treatment options. Different studies show a favourable effect of he botuline
toxine A detrusorinjections for treatment of the neurogenic overactive bladder. Therefore we
started a multicentric pilot study with botulin detrusorinjections for patients with therapy
resistent non-neurogenic overactive bladder. This is the first study which evaluates the effect
of botuline toxin A on objective parameters and quality of life scores for the treatment of nonneurogenic
Pre-treatment evaluation of all patients consisted of physical examination, neuro-urologic
evaluation,urineculture, urinecytology, cystoscopy, micturation diary, King’s College Health
scores and urodynamic examination.
The treatment was performed under general anesthesia in one day clinic setting. Patients
were given 20 separate botuline toxine A injections (Dysport®) in the detrusor sparing the
trigonum. In total 500 units Dysport® were injected with a cystoscopic Williams
needle(Cook®). During follow-up patients were evaluated with physical examination,
micturation diary, King’s College Health Questionnaire at week 0, 2, 12 and at 6 and 9
months. At week 12 a standard urodynamic examination was performed.
15 patients were treated in three separate urologic centers. Maximum follow-up is 9 months.
None of the patients suffered from local or systemic complications due the technique or toxin.
There is an improvement of the incontinence impact score with 54%, the physical and social
impact score with 54% respectively 55,5% after three months. Frequency decreases from
16,5 to 12,4 micturations a day and urgency diminishes with 5,4 episodes a day as well.
Almost all incontinent patients stay dry which results in only one or less pads a day for each
patient. On urodynamic evaluation after 3 months we see a mean increase of the cystometric
bladdercapacity from 216 to 323ml(p<0,01). Average volume at first desire to void increases
from 98 to 156 ml(p<0,01). Mean post mictional residue does never exceed 26 ml.
The results at 6 and 9 months follow-up are promising for patients with non-neurogenic
overactive bladder resistant to conservative treatments. There were no serious
complications encountered with a dose of 500 units Dysport. There is an obvious
improvement of all subjective parameters from King’s College Health Questionnaire.
Objective parameters such as a three-day micturation diary, cystometric bladdercapacity and
the volume at first desire to void improve significantly. On the congress we will present our
results after one year follow-up.