PMID- 27023603
OWN - NLM
STAT- MEDLINE
DCOM- 20161215
LR  - 20181202
IS  - 2072-6651 (Electronic)
IS  - 2072-6651 (Linking)
VI  - 8
IP  - 4
DP  - 2016 Mar 25
TI  - Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Patients with 
      Frailty, Medical Comorbidities or Prior Lower Urinary Tract Surgery.
PG  - 91
LID - 10.3390/toxins8040091 [doi]
LID - 91
AB  - Overactive bladder (OAB) symptoms increase with age and involve several 
      comorbidities. OnabotulinumtoxinA (BoNT-A) intravesical injection is a treatment 
      choice for patients who are intolerant of or refractory to antimuscarinics. 
      However, the increased risk of urinary tract infection and elevated post-void 
      residual (PVR) volume post-treatment require resolution. Male sex, baseline PVR > 
      100 mL, and comorbidities are independent risk factors of adverse events (AEs) 
      such as acute urinary retention (AUR). Intravesical BoNT-A injection is safe and 
      effective for OAB patients with frailty, medical comorbidities such as 
      Parkinson's disease (PD), chronic cerebrovascular accidents (CVA), dementia, or 
      diabetes, or a history of prior lower urinary tract surgery (prostate or 
      transvaginal sling surgery). Post-treatment, 60% of frail elderly patients had a 
      PVR volume > 150 mL and 11% had AUR. Although intravesical BoNT-A injection is 
      safe for PD patients, CVA patients had higher strain voiding rates. Diabetic 
      patients were at increased risk of large PVR urine volume and general weakness 
      post-treatment. Treatment results were similar between patients with and without 
      a history of prostate or transvaginal sling surgery. Possible AEs and bladder 
      management strategies should be conveyed to patients before treatment. Careful 
      patient selection is important, and therapeutic safety and efficacy should be 
      carefully balanced.
FAU - Liao, Chun-Hou
AU  - Liao CH
AD  - Department of Urology, Cardinal Tien Hospital and School of Medicine, Fu-Jen 
      Catholic University, Taipei 24205, Taiwan. liaoch0321@gmail.com.
FAU - Wang, Chung-Cheng
AU  - Wang CC
AD  - Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan 
      University, Taipei 23702, Taiwan. ericwcc@ms27.hinet.net.
AD  - Department of Biomedical Engineering, Chung Yuan Christian University, Chung-Li 
      32023, Taiwan. ericwcc@ms27.hinet.net.
FAU - Jiang, Yuan-Hong
AU  - Jiang YH
AD  - Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 
      Hualien 97002, Taiwan. redeemer1019@yahoo.com.tw.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160325
PL  - Switzerland
TA  - Toxins (Basel)
JT  - Toxins
JID - 101530765
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Administration, Intravesical
MH  - Aged
MH  - Botulinum Toxins, Type A/*administration & dosage/therapeutic use
MH  - Central Nervous System Diseases/drug therapy
MH  - Comorbidity
MH  - Diabetes Mellitus/drug therapy
MH  - Frail Elderly
MH  - Humans
MH  - Male
MH  - Prostate/surgery
MH  - Urinary Bladder, Overactive/*drug therapy
MH  - Urinary Tract/surgery
PMC - PMC4848618
OTO - NOTNLM
OT  - Type A
OT  - botulinum toxin
OT  - comorbidity
OT  - frail elderly
OT  - overactive
OT  - urinary bladder
EDAT- 2016/03/31 06:00
MHDA- 2016/12/16 06:00
PMCR- 2016/04/01
CRDT- 2016/03/30 06:00
PHST- 2016/02/02 00:00 [received]
PHST- 2016/03/16 00:00 [revised]
PHST- 2016/03/18 00:00 [accepted]
PHST- 2016/03/30 06:00 [entrez]
PHST- 2016/03/31 06:00 [pubmed]
PHST- 2016/12/16 06:00 [medline]
PHST- 2016/04/01 00:00 [pmc-release]
AID - toxins8040091 [pii]
AID - toxins-08-00091 [pii]
AID - 10.3390/toxins8040091 [doi]
PST - epublish
SO  - Toxins (Basel). 2016 Mar 25;8(4):91. doi: 10.3390/toxins8040091.