PMID- 20864251
OWN - NLM
STAT- MEDLINE
DCOM- 20110707
LR  - 20110318
IS  - 1873-7560 (Electronic)
IS  - 0302-2838 (Linking)
VI  - 58
IP  - 6
DP  - 2010 Dec
TI  - Adverse events of intravesical botulinum toxin a injections for idiopathic 
      detrusor overactivity: risk factors and influence on treatment outcome.
PG  - 919-26
LID - 10.1016/j.eururo.2010.09.007 [doi]
AB  - BACKGROUND: Intravesical injection of botulinum toxin type A (BoNTA) provides 
      effective treatment for detrusor overactivity and overactive bladder (OAB). 
      However, the high rates of treatment-related adverse events (AEs) prevent its 
      more widespread use. OBJECTIVE: To investigate the risk factors of increasing AEs 
      after BoNTA injection for idiopathic detrusor overactivity (IDO). DESIGN, 
      SETTING, AND PARTICIPANTS: This study included a total of 217 patients receiving 
      their first intravesical BoNTA injection for refractory IDO in a tertiary 
      university hospital from 2004 to 2009. MEASUREMENTS: AE incidence was analyzed 
      according to gender, age, comorbidities, prostate condition in men, OAB subtype, 
      BoNTA dose, injection site, and baseline urodynamic parameters. Successful 
      outcome was determined based on patient perception of improvement of bladder 
      condition at 3 mo. RESULTS AND LIMITATIONS: Successful outcomes were reported by 
      144 (66.3%) patients. By multivariable analysis, male gender (p=0.013) and 
      baseline postvoid residual (PVR) >/=100ml (p=0.003) were independent predictors of 
      acute urinary retention (AUR). Baseline PVR >/=100ml (p=0.007) and receiving >100 U 
      BoNTA (p=0.029) were predictors of straining to void. The incidence of large PVR 
      after treatment was associated with comorbidity (p=0.011). Urinary tract 
      infection occurred more frequently in women (p=0.003) and in men with retaining 
      prostate (p=0.008). No AUR developed after bladder base/trigonal injection. 
      Nevertheless, the occurrence of AUR or large PVR did not affect therapeutic 
      outcome. This study is limited by nonconsecutive enrollment of patients. 
      CONCLUSIONS: Male gender, baseline PVR >/=100ml, comorbidity, and BoNTA dose >100 U 
      are risk factors for increasing incidence of AEs after intravesical BoNTA 
      injection for IDO.
CI  - Copyright (c) 2010 European Association of Urology. Published by Elsevier B.V. All 
      rights reserved.
FAU - Kuo, Hann-Chorng
AU  - Kuo HC
AD  - Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 
      Hualien, Taiwan. hck@tzuchi.com.tw
FAU - Liao, Chun-Hou
AU  - Liao CH
FAU - Chung, Shiu-Dong
AU  - Chung SD
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20100917
PL  - Switzerland
TA  - Eur Urol
JT  - European urology
JID - 7512719
RN  - 0 (Neuromuscular Agents)
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Administration, Intravesical
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Botulinum Toxins, Type A/administration & dosage/*adverse effects
MH  - Chi-Square Distribution
MH  - Comorbidity
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Hospitals, University
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Neuromuscular Agents/administration & dosage/*adverse effects
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sex Factors
MH  - Taiwan
MH  - Time Factors
MH  - Treatment Outcome
MH  - Urinary Bladder/*drug effects/physiopathology
MH  - Urinary Bladder, Overactive/*drug therapy/physiopathology
MH  - Urodynamics/drug effects
MH  - Young Adult
EDAT- 2010/09/25 06:00
MHDA- 2011/07/08 06:00
CRDT- 2010/09/25 06:00
PHST- 2010/06/17 00:00 [received]
PHST- 2010/09/06 00:00 [accepted]
PHST- 2010/09/25 06:00 [entrez]
PHST- 2010/09/25 06:00 [pubmed]
PHST- 2011/07/08 06:00 [medline]
AID - S0302-2838(10)00862-6 [pii]
AID - 10.1016/j.eururo.2010.09.007 [doi]
PST - ppublish
SO  - Eur Urol. 2010 Dec;58(6):919-26. doi: 10.1016/j.eururo.2010.09.007. Epub 2010 Sep 
      17.