PMID- 35696022
OWN - NLM
STAT- MEDLINE
DCOM- 20220628
LR  - 20220924
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 39
IP  - 6
DP  - 2022 Jun
TI  - Bladder Dysfunction in Older Adults: The Botulinum Toxin Option.
PG  - 401-416
LID - 10.1007/s40266-022-00950-1 [doi]
AB  - Bladder dysfunction, which involves inadequacies of urine storage or emptying, 
      increases with age. Conventional medications may have insufficient efficacy for 
      patients with refractory lower urinary tract symptoms, and their concomitant 
      adverse events (AEs) may be intolerable for the older adult population. For 
      decades, the botulinum toxin type A (BoNT-A) injection has been an option for 
      managing urine frequency, urge incontinence, and voiding dysfunction in the 
      general population refractory to conventional management. This review focuses on 
      studies of BoNT-A application in the management of bladder dysfunction in older 
      adult patients aged >/= 65 years. In this target population, intravesical BoNT-A 
      injections provide similar efficacy in idiopathic overactive bladder to that in 
      younger adults. Good clinical response has also been demonstrated in older adult 
      patients presenting with storage dysfunction and with various concomitant 
      underlying neurological diseases. However, caution must be taken for the AEs that 
      occur after intravesical BoNT-A injection, including increased post-void residual 
      urine, acute urine retention, and urinary tract infection. Most evidence shows 
      that age is not a major determinant of AEs after adjusting for other factors. In 
      contrast to its application in storage dysfunction, evidence for voiding 
      dysfunction in older adults is scarce. In general, BoNT-A may be a reasonable 
      option for older adult patients with refractory storage dysfunction because of 
      its promising clinical response without significant systemic AEs. Overall, 
      clinicians should be aware of the balance between the therapeutic efficacy of 
      BoNT-A and local AEs in vulnerable members of this population.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
FAU - Kao, Yao-Lin
AU  - Kao YL
AD  - Department of Urology, National Cheng Kung University Hospital, College of 
      Medicine, National Cheng Kung University, Tainan, 704, Taiwan.
FAU - Ou, Yin-Chien
AU  - Ou YC
AD  - Department of Urology, National Cheng Kung University Hospital, College of 
      Medicine, National Cheng Kung University, Tainan, 704, Taiwan.
AD  - Institute of Clinical Medicine, College of Medicine, National Cheng Kung 
      University, Tainan, 704, Taiwan.
FAU - Kuo, Hann-Chorng
AU  - Kuo HC
AD  - Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical 
      Foundation and Tzu Chi University, No. 707, Section 3, Chung Yang Road, Hualien, 
      970, Taiwan. hck@tzuchi.com.tw.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20220613
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Aged
MH  - *Botulinum Toxins, Type A/adverse effects
MH  - Humans
MH  - Treatment Outcome
MH  - Urinary Bladder
MH  - *Urinary Bladder, Overactive/drug therapy
EDAT- 2022/06/14 06:00
MHDA- 2022/06/29 06:00
CRDT- 2022/06/13 11:21
PHST- 2022/05/02 00:00 [accepted]
PHST- 2022/06/14 06:00 [pubmed]
PHST- 2022/06/29 06:00 [medline]
PHST- 2022/06/13 11:21 [entrez]
AID - 10.1007/s40266-022-00950-1 [pii]
AID - 10.1007/s40266-022-00950-1 [doi]
PST - ppublish
SO  - Drugs Aging. 2022 Jun;39(6):401-416. doi: 10.1007/s40266-022-00950-1. Epub 2022 
      Jun 13.