These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo .
However , there were no significant differences between some dosages .
Compared with placebo , the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications .
Conclusions In consideration that the treatments of BTX-A were with minimal , local , and manageable adverse effects , this meta- analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U .
Purpose To assess the effectiveness and safety of botulinum toxin A ( BTX-A ) at different dosages for overactive bladder ( OAB ) .
Botulinum A toxin injections into the detrusor: an effective treatment in idiopathic and neurogenic detrusor overactivity?
AIMS To assess and compare the effect of botulinum A toxin ( BTX-A ) injections into the detrusor in idiopathic and neurogenic detrusor overactivity resistant to anticholinergic treatment . PATIENTS AND METHODS In a prospect i ve study , 11 patients with idiopathic and 11 with neurogenic detrusor overactivity resistant to anticholinergic treatment were injected with 300 U of BTX-A ( Botox ) into the detrusor . Clinical and urodynamic parameters were assessed before and after BTX-A injections . RESULTS In idiopathic as well as in neurogenic detrusor overactivity , median daytime frequency decreased significantly from 11 to 4 ( P = 0.004 ) and 12 to 5 ( P = 0.001 ) , median nocturia from 3 to 1 ( P = 0.004 ) and 3 to 1 ( P = 0.001 ) , and median number of used pads from 5 to 0 ( P = 0.001 ) and 5 to 0 ( P = 0.002 ) , respectively . There was a significant increase in median maximum cystometric capacity from 220 to 340 ml ( P = 0.001 ) and 190 to 410 ml ( to instead of ) ( P = 0.001 ) , median bladder compliance from 20 to 55 ml/cm H(2)O ( P = 0.001 ) and 23 to 60 ml/cm H(2)O ( P = 0.004 ) and median post void residual from 10 to 140 ml ( P = 0.002 ) and 30 to 240 ml ( P = 0.002 ) , respectively . Median maximum detrusor pressure decreased significantly from 45 to 29 cm H(2)O ( P = 0.002 ) and 40 to 24 cm H(2)O ( P = 0.002 ) , and median detrusor pressure at maximum flow rate from 30 to 14 ml/sec ( P = 0.001 ) and 38 to 21 ml/sec ( P = 0.016 ) , respectively . Due to post void residuals > 150 ml following BTX-A injections , de novo clean intermittent self-catheterization was necessary in nine patients ( four with idiopathic and five with neurogenic detrusor overactivity ) and in one patient ( with idiopathic detrusor overactivity ) a suprapubic catheter was placed . The effect of BTX-A injections lasted for a median time of 5 months in both idiopathic and neurogenic detrusor overactivity . There was no significant difference in idiopathic compared to neurogenic detrusor overactivity in regard to clinical and urodynamic parameters assessed before and after BTX-A injections . CONCLUSIONS BTX-A injections into the detrusor have a significant and comparable but temporally limited effect in idiopathic and neurogenic detrusor overactivity resistant to anticholinergic treatment
These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo .
However , there were no significant differences between some dosages .
Compared with placebo , the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications .
Conclusions In consideration that the treatments of BTX-A were with minimal , local , and manageable adverse effects , this meta- analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U .
Purpose To assess the effectiveness and safety of botulinum toxin A ( BTX-A ) at different dosages for overactive bladder ( OAB ) .