Vol. 43 (6): 1122-1128, November – December, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0622


Maryam Emami 1, Pejman Shadpour 1, Amir H. Kashi 1, Masoud Choopani 1, Mohammadreza Zeighami 1
1 Hasheminejad Kidney Center (HKC), Iran University of Medical Sciences (IUMS), Tehran, Iran



Purpose: To evaluate if the injections of abobotulinum-A toxin in trigone and blad­der neck/prostatic urethra in addition to detrusor provides better symptoms relief and urodynamic findings in patients with idiopathic detrusor overactivity (IDO) refractory to medical treatment.

Materials and Methods: A total of 74 patients with IDO refractory to anticholinergics received injections in detrusor, trigone and bladder neck/prostatic urethra (Group A, N=36) versus detrusor only injections (Group B, N=38) of abobotulinum-A toxin. All patients were evaluated by a standard overactive bladder symptom score (OABSS) questionnaire and cystometrography before and 6 weeks after the operation. OABSS questionnaire was also completed 20 weeks after the operation.

Results: The magnitude of OABSS reduction from baseline to 6 weeks after operation in groups A and B patients was 13.4±2.2 versus 11.7±2.1 (p=0.001). Cystometry results were similar in both groups except for higher volume at urgent desire to void in Group B patients (p <0.001). The mean±SD change in residual volume in Group A at 6 weeks after the operation was -4.8±28.6mL (p=0.33) compared to 21.3±16.9mL in Group B patients (p <0.001).

Conclusions: In patients with IDO, adding trigone, and bladder neck/prostatic urethra as sites of abobotulinum- A toxin injection produces greater reductions in OABSS score and less residual urine volume but a lower volume at urgent desire to void in comparison with detrusor only injections.

Keywords:  Urinary Bladder, Overactive; Botulinum Toxins

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