Botulinum Toxin A for Overactive Bladder and Detrusor Muscle Overactivity in Patients With Parkinson's Disease and Multiple System Atrophy

Antonella Giannantoni, Aroldo Rossi, Ettore Mearini, Michele Del Zingaro, Massimo Porena, Alfredo Berardelli

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Purpose: Urinary disturbances are common in patients with Parkinson's disease and multiple system atrophy. We investigated the effectiveness and safety of botulinum toxin type A injected into the detrusor muscle in patients with Parkinson's disease and multiple system atrophy who had refractory overactive bladder symptoms and detrusor overactivity. Materials and Methods: All participants underwent clinical and urodynamic assessment, and completed a quality of life questionnaire before botulinum toxin type A treatment, and 1 and 3 months thereafter. Four patients with Parkinson's disease and 2 with multiple system atrophy were enrolled in the study. All patients received 200 U botulinum toxin type A injected into the detrusor muscle at 20 sites under cystoscopic guidance at a single session on an inpatient basis. Outcome measures were clinical assessment (a voiding diary including daytime and nighttime urinary frequency, and episodes of urgency and urge urinary incontinence), urodynamic assessment (including first volume and maximum pressure of uninhibited detrusor contractions, and maximum cystometric capacity) and pressure flow studies. Results: One and 3 months after botulinum toxin type A injection all patients reported that daytime and nighttime urinary frequency had decreased and quality of life scores improved. No patients had further episodes of urgency and urge urinary incontinence during the 5-month followup. Urodynamics showed improvement in all urinary function variables tested. No systemic side effects were recorded during or after treatment. In all patients post-void urinary residual volume increased and intermittent catheterization was required only in those with multiple system atrophy. Conclusions: The new beneficial effect that we report in a small study sample encourages larger trials to confirm botulinum toxin type A injection into the detrusor muscle as an effective and safe treatment for refractory overactive bladder symptoms and detrusor overactivity related to Parkinson's disease and multiple system atrophy.

Original languageEnglish
Pages (from-to)1453-1457
Number of pages5
JournalJournal of Urology
Volume182
Issue number4 SUPPL.
DOIs
Publication statusPublished - Oct 2009

Fingerprint

Multiple System Atrophy
Overactive Urinary Bladder
Type A Botulinum Toxins
Parkinson Disease
Muscles
Urodynamics
Urge Urinary Incontinence
Quality of Life
Pressure
Injections
Residual Volume
Parkinsonian Disorders
Catheterization
Inpatients
Therapeutics
Outcome Assessment (Health Care)
Safety

Keywords

  • botulinum toxins
  • multiple system atrophy
  • overactive
  • Parkinson disease
  • quality of life
  • urinary bladder

ASJC Scopus subject areas

  • Urology

Cite this

Botulinum Toxin A for Overactive Bladder and Detrusor Muscle Overactivity in Patients With Parkinson's Disease and Multiple System Atrophy. / Giannantoni, Antonella; Rossi, Aroldo; Mearini, Ettore; Del Zingaro, Michele; Porena, Massimo; Berardelli, Alfredo.

In: Journal of Urology, Vol. 182, No. 4 SUPPL., 10.2009, p. 1453-1457.

Research output: Contribution to journalArticle

Giannantoni, Antonella ; Rossi, Aroldo ; Mearini, Ettore ; Del Zingaro, Michele ; Porena, Massimo ; Berardelli, Alfredo. / Botulinum Toxin A for Overactive Bladder and Detrusor Muscle Overactivity in Patients With Parkinson's Disease and Multiple System Atrophy. In: Journal of Urology. 2009 ; Vol. 182, No. 4 SUPPL. pp. 1453-1457.
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