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Wirkung von Botulinumtoxin A in der ein- und mehrmaligen Behandlung der überaktiven Blase

Eine prospektive Analyse

Effects of botulinum toxin type A in the single and repeated treatment of overactive bladder

A prospective analysis

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Zusammenfassung

Hintergrund

Die Symptome der nichtneurogenen überaktiven Blase (OAB) führen bei den Betroffenen zu einer deutlichen Reduktion der Lebensqualität (QoL). Bei Versagen der konservativen Therapie ist die Injektion von Botulinumtoxin A (BTX-A) in die Harnblasenwand eine weitere Option. Das Ziel dieser prospektiven Studie war die Beurteilung der Wirksamkeit der ein- und mehrmaligen BTX-A-Injektion in den Detrusor vesicae.

Ergebnisse

Mit 500 „mouse units“ (MU) BTX-A (Dysport®) wurden 40 Patienten mit nichtneurogener OAB behandelt. Die QoL, Änderung der Miktionsfrequenz, Nebenwirkungen und die Wirkdauer wurden prospektiv erhoben. Der mediane Follow-up betrug 9 Monate. Die mittlere Frequenz sank in 81% tagsüber (p<0,001), die Nykturie reduzierte sich in 68% (p=0,009). Die mittlere Wirkdauer betrug 6 Monate. Eine Verbesserung der QoL wurde bei 83% der Patienten erreicht. Außer einer vorübergehenden Harnretention in 4 Fällen traten keine schweren Nebenwirkungen auf.

Schlussfolgerung

Die Ergebnisse unserer prospektiven Studie zeigen, dass die Anwendung von BTX-A eine sichere und höchst wirksame Behandlungsoption für Patienten mit Anticholinergika-refraktärer OAB darstellt.

Abstract

Background

Quality of life (QoL) is negatively affected by the symptoms of overactive bladder (OAB). Standard treatment is the administration of anticholinergics, which are associated with nasty adverse effects. The aim of this prospective study was to evaluate the efficacy of singular and repeated botulinum-A toxin (BTX-A) injections in the bladder detrusor muscle in patients suffering nonneurogenetic OAB.

Results

Forty patients with OAB were treated with 500 mouse units of BTX-A (Dysport). Subjective satisfaction, micturition data, side effects, and the duration of effect were evaluated prospectively. The median follow-up was 9 months. The mean daily frequency decreased in 81% (p<0.001) of the patients, and nocturia decreased in 68% (p=0.009). The mean duration of effect until recurrence of OAB symptoms was 6 months. Using a visual analogue scale, subjective improvement in QoL was achieved in 83% of patients. Except for temporary urine retention in four cases, no severe side effects occurred.

Conclusion

The results of our prospective study show that the endoscopic application of BTX-A is a safe and highly effective treatment option for patients with OAB refractory to conventional treatment.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: A.H. erhält Unterstützungen für Forschungsprojekte von der Firma Ipsen Pharma GmbH. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Universitätsklinikum Gießen und Marburg,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland

    C. Frohme, P. Olbert, A.J. Schrader, R. Hofmann & A. Hegele

  2. Abteilung für Urologie und Kinderurologie, Kliniken des Landkreises Sigmaringen, Sigmaringen, Deutschland

    Z. Varga

Authors
  1. C. Frohme
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  2. Z. Varga
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  3. P. Olbert
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  4. A.J. Schrader
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  5. R. Hofmann
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  6. A. Hegele
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Correspondence to C. Frohme.

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Frohme, C., Varga, Z., Olbert, P. et al. Wirkung von Botulinumtoxin A in der ein- und mehrmaligen Behandlung der überaktiven Blase. Urologe 49, 639–644 (2010). https://doi.org/10.1007/s00120-009-2208-9

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  • DOI: https://doi.org/10.1007/s00120-009-2208-9

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