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Efficacy and safety of the first and repeated intradetrusor injections of abobotulinum toxin A 750 U for treating neurological detrusor overactivity

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Abstract

Purpose

To assess clinical and urodynamic efficacy of the first and repeated intradetrusor injections of abobotulinum toxin A (Dysport®, Ipsen®, France) in patients with neurogenic detrusor overactivity (NDO) refractory to anticholinergic treatment.

Methods

A single-center retrospective study was conducted in 81 consecutive patients who had never received any botulinum toxin intradetrusor injections. They were treated with at least one 750 U intradetrusor injection of abobotulinum toxin A. All patients performed clean intermittent self-catheterization (CIC) before injections. Success was defined as a combination of no incontinence episode, a number of catheterization <8 reported in a 3-day bladder diary and the lack of detrusor overactivity.

Results

Six weeks after the first injection, the success rate was 64.2 %. The proportion of continent patients was 80.2 %, the mean number of CIC per 24 h reduced (−3.55, p < 0.0001) and the mean catheterization volume increased (+237.3 ml, p < 0.0001). Regarding urodynamics, mean maximum cystometric capacity and mean volume at the first uninhibited contraction increased (+132.7 ml, p < 0.0001 and +180 ml, p < 0.0001, respectively) and mean maximum bladder pressure decreased significantly (−21.5 cm H2O, p < 0.0001). Mean reinjection number was 3.9 and mean interval between reinjection was 8.8 ± 3 months. The clinical efficacy rate after each reinjection (up to fourteen) was at least 86.7 %. Out of 55 patients who underwent repeated injections, secondary resistance was noted in 2 (3.6 %).

Conclusion

The results of the present study are in favor of a long-term safety and efficacy of abobotulinum toxin A 750 U for NDO.

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Author’s contribution

Benoit Peyronnet, Xavier Gamé, and Pascal Rischmann developed protocol/project. Benoit Peyronnet, Mathieu Roumiguié, and Julien Guillotreau collected or managed data. Benoit Peyronnet, Xavier Gamé, Evelyne Castel-Lacanal, and Philippe Marque analyzed data. Benoit Peyronnet, Mathieu Roumiguié, and Xavier Gamé wrote/edited manuscript.

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Correspondence to Benoit Peyronnet.

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Conflict of interest

Xavier Gamé is a consultant for Ipsen and a consultant and speaker bureau for Allergan. Julien Guillotreau is a consultant for Allergan. Other authors have nothing to disclose.

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Peyronnet, B., Roumiguié, M., Castel-Lacanal, E. et al. Efficacy and safety of the first and repeated intradetrusor injections of abobotulinum toxin A 750 U for treating neurological detrusor overactivity. World J Urol 34, 755–761 (2016). https://doi.org/10.1007/s00345-015-1666-5

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  • DOI: https://doi.org/10.1007/s00345-015-1666-5

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