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• W2605258596 abstract "You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction II1 Apr 2017PD64-07 INTRADETRUSOR INJECTIONS OF BOTULINUM TOXIN A IN ADULT PATIENTS WITH SPINAL DYSRAPHISM: RESULTS OF A MULTICENTER STUDY benoit peyronnet, alexia even, alix verrando, gregoire capon, marianne de séze, juliette hascoet, claire lenormand, charlotte maurin, xavier biardeau, laure monleon, jacques kerdraon, evelyne castel-lacanal, francois marcelli, maximilien baron, marie-aimée perrouin-verbe, clément allenet, pascal mouracade, boutin jean-michel, christian saussine, philippe grise, loic lenormand, emmanuel chartier-kastler, jean-nicolas cornu, gilles karsenty, brigitte schurch, pierre denys, gerard amarenco, andrea manunta, and xavier gamé benoit peyronnetbenoit peyronnet More articles by this author , alexia evenalexia even More articles by this author , alix verrandoalix verrando More articles by this author , gregoire capongregoire capon More articles by this author , marianne de sézemarianne de séze More articles by this author , juliette hascoetjuliette hascoet More articles by this author , claire lenormandclaire lenormand More articles by this author , charlotte maurincharlotte maurin More articles by this author , xavier biardeauxavier biardeau More articles by this author , laure monleonlaure monleon More articles by this author , jacques kerdraonjacques kerdraon More articles by this author , evelyne castel-lacanalevelyne castel-lacanal More articles by this author , francois marcellifrancois marcelli More articles by this author , maximilien baronmaximilien baron More articles by this author , marie-aimée perrouin-verbemarie-aimée perrouin-verbe More articles by this author , clément allenetclément allenet More articles by this author , pascal mouracadepascal mouracade More articles by this author , boutin jean-michelboutin jean-michel More articles by this author , christian saussinechristian saussine More articles by this author , philippe grisephilippe grise More articles by this author , loic lenormandloic lenormand More articles by this author , emmanuel chartier-kastleremmanuel chartier-kastler More articles by this author , jean-nicolas cornujean-nicolas cornu More articles by this author , gilles karsentygilles karsenty More articles by this author , brigitte schurchbrigitte schurch More articles by this author , pierre denyspierre denys More articles by this author , gerard amarencogerard amarenco More articles by this author , andrea manuntaandrea manunta More articles by this author , and xavier gaméxavier gamé More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2944AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The DIGNITY randomized controlled trials have lead botulinum toxin A to be licensed for neurogenic detrusor overactivity (NDO) but included only spinal cord injured and multiple sclerosis patients. To date, no data has been published regarding the efficacy of intradetrusor botulinum toxin injections (IDBTI) in patients with spinal dysraphism while these patients are injected in numerous centers in daily practice. The aim of the present study was to report the outcomes of IDBTI in spina bifida patients. METHODS All patients with spinal dysraphism who had undergone at least one IDBTI from 2002 ro 2016 in 14 centers were included retrospectively. Patients bleow the age of 16 years old were excluded to focus on an adult population. The primary endpoint was the success of injections, defined as as the combination of urgency, urinary incontinence and detrusor overactivity resolution. Datas collected included patients' characteristics, adverse events, and urodynamics parameters before and 6 weeks after IDBTI. The impact of poor compliance (defined as bladder compliance < 20 ml/cm H2O) and type of spinal dysraphism on outcomes was assessed through univariate analyses. RESULTS After exclusion of 53 children, 125 patients who underwent a total of 561 IDBTI courses were included (1 to 17 courses per patient). The urodynamic patterns were detrusor overactivity in 48.6% of patients, isolated poor compliance in 33.6% of patients and combination of poor compliance and detrusor overactivity in 17.8%. The toxin used was in the vast majority onabotulinum toxin A at a dosage of 200 U in 43 patients (34.7%) and 300 U in 62 patients (49.2%). Twenty patients (16.1%) received initially abobotulinum toxin A 750 injections. Global success rate of the first injection was 68.8% with resolution of urinary incontinence in 73.5% of patients. Ninety-six patients (76.8%) underwent a second injection and the mean interval between the first and second injections was 7.5 months. Success rate was significantly lower in case of poor compliance (49% vs. 87%; p<0.0001). In contrast, success rates did not differ significantly between open and closed spinal dysraphism (66.7% vs. 72.3%; p=0.51). The two other predictors of success were female vs. male gender (83.3% vs. 51.7%; p=0.0002) and age (OR=0.1; p=0.005). Out of 561 injections, 20 adverse events were noted (3.6%) including three fatigue/muscular weakness. CONCLUSIONS IDBTI seems effective in spina bifida patients showing detrusor overactivity regardless of the type of spinal dysraphism (open or closed). In contrast, the effectiveness is much lower in spina bifida patients with poor compliance bladder. The safety of IDBTI in patients with spinal dysraphism is statisfactory © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1262-e1263 Advertisement Copyright & Permissions© 2017MetricsAuthor Information benoit peyronnet More articles by this author alexia even More articles by this author alix verrando More articles by this author gregoire capon More articles by this author marianne de séze More articles by this author juliette hascoet More articles by this author claire lenormand More articles by this author charlotte maurin More articles by this author xavier biardeau More articles by this author laure monleon More articles by this author jacques kerdraon More articles by this author evelyne castel-lacanal More articles by this author francois marcelli More articles by this author maximilien baron More articles by this author marie-aimée perrouin-verbe More articles by this author clément allenet More articles by this author pascal mouracade More articles by this author boutin jean-michel More articles by this author christian saussine More articles by this author philippe grise More articles by this author loic lenormand More articles by this author emmanuel chartier-kastler More articles by this author jean-nicolas cornu More articles by this author gilles karsenty More articles by this author brigitte schurch More articles by this author pierre denys More articles by this author gerard amarenco More articles by this author andrea manunta More articles by this author xavier gamé More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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