We evaluated our results with low dose intradetrusor injections of onabotulinu - mtoxinA in women with overactive bladder symptoms and the painful bladder syndrome in terms of clinically successful outcomes and the need for clean intermittent self-catheterization (CISC) and in relation to urodynamic aspects. The files of patients treated with 100 U of onabotulinumtoxinA injected at 20 sites with sparing of the trigone were retrospectively analyzed. Nearly all patients completed voiding- incontinence diaries and the King’s Health Questionnaire (KHQ) pre- and post-operatively. Cystometric and pressure-flow studies were done in the majority of patients. Success was defined as the patient’s and clinician’s joint choice for re-treatment with the same dose of onabotulinumtoxinA after a period of at least six months of clinical satisfaction. Twenty-six women were treated. On average, the improvement in most voiding diary parameters and in most KHQ categories lasted less than six and three months, respectively. Eight patients (31%) were scheduled for re-treatment with 100 U again after at least six months. No prognostic cystometric parameters were found. Six patients (23%) needed CISC. None of the bladder contraction strength parameters derived from the pressure-flow studies appeared predictive of the need of CISC. We obtained a success rate of 31% after six months with 100 U of onabotulinumtoxinA, while 23% of the patients applied CISC. We consider this success rate low and find the balance between the success rate and the rate of patients needing CISC inadequate.
Palliative Care Intervention Trials for Adults Living with Progressive Central Nervous System Diseases and Their Caregivers: A Systematic Review
