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Toxins 2016, 8(3), 75; doi:10.3390/toxins8030075

Adverse Events of Intravesical OnabotulinumtoxinA Injection between Patients with Overactive Bladder and Interstitial Cystitis—Different Mechanisms of Action of Botox on Bladder Dysfunction?

1
Department of Urology, Yangming Branch of Taipei City Hospital, Taipei 11146, Taiwan
2
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Taipei 11146, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editors: Joseph Jankovic and Flaminia Pavone
Received: 17 January 2016 / Revised: 29 February 2016 / Accepted: 7 March 2016 / Published: 16 March 2016
(This article belongs to the Special Issue Botulinum Toxin A on Lower Urinary Tract Dysfunction)
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Abstract

Intravesical onabotulinumtoxinA (BoNT-A) injections have been proposed to treat both overactive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS) in patients with refractory conditions. We compared adverse events (AEs) after BoNT-A treatment between IC/BPS and OAB in women. IC/BPS patients who failed conventional treatments were enrolled to receive suburothelial injections of BoNT-A (100 U) followed by hydrodistention. Age matched OAB female patients refractory to antimuscarinic agents underwent BoNT-A (100 U) injections. The bladder capacity, maximum flow rate (Qmax), post-void residual (PVR), and voiding efficiency (VE) at baseline, 3 and 6 months, and the post-treatment AEs were analyzed between groups. Finally, 89 IC/BPS and 72 OAB women were included. In the OAB group, the bladder capacity and PVR increased, and VE decreased significantly at three and six months after BoNT-A treatment. In the IC/BPS group, the Qmax increased significantly at six months. There were significant differences in changes of capacity, Qmax, PVR and VE between the two groups. Moreover, OAB patients suffered more frequently from events of hematuria, UTI, and large PVR (>200 mL), but less frequently from events of straining to void. In conclusion, OAB women had higher PVR volume and lower VE than those in IC/BPS after BoNT-A injections. These results imply that the bladder contractility of OAB patients are more susceptible to BoNT-A, which might reflect the different mechanisms of action of Botox on bladder dysfunction. Further investigations to confirm this hypothesis are warranted. View Full-Text
Keywords: onabotulinumtoxinA; adverse events; interstitial cystitis; overactive bladder onabotulinumtoxinA; adverse events; interstitial cystitis; overactive bladder
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Kuo, Y.-C.; Kuo, H.-C. Adverse Events of Intravesical OnabotulinumtoxinA Injection between Patients with Overactive Bladder and Interstitial Cystitis—Different Mechanisms of Action of Botox on Bladder Dysfunction? Toxins 2016, 8, 75.

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