Botulinum toxin A submucosal injection for refractory non-neurogenic XXXX : early outcomes.

@entity1 @entity322 @entity2182
The objective of the present study was to assess the short-term effects of botulinum toxin A (BTX-A) injection for refractory non-neurogenic @entity2182 ( @entity2182 ) in the setting of a prospective multicenter clinical trial. Refractory @entity2182 was defined as persistent urgency urinary @entity322 (UUI) >=  once a week despite taking anticholinergic agents, or the incapability to continue the agents because of the adverse effects. A total of 100 U of BTX-A were reconstituted in 15 mL of normal saline and an aliquot of 0.5 mL was injected at 30 submucosal sites of the bladder wall. Nine @entity1 and eight @entity1 aged 67    12 years were included. Subjective daytime frequency, urgency and UUI significantly decreased after treatment. On a 3-day frequency-volume chart, the daytime and night-time frequency of UUI significantly decreased from 5.5 and 0.5 pre-injection to 2.0 and 0.3 postinjection, respectively. Daytime urinary @entity322 completely disappeared in six subjects. A urodynamic study showed the disappearance of detrusor overactivity in eight @entity1 and a decrease in five @entity1 . Maximum bladder capacity significantly increased from 179.9 to 267.3 mL. Difficulty on micturition or feeling of incomplete emptying was reported by 23.5% and 43.8% of @entity1 at weeks 2 and 4, respectively. Postvoid residual urine increased to >100 mL in seven @entity1 and >200 mL in one @entity1 after injection; however, none of the @entity1 required clean intermittent catheterization. These findings suggest promising efficacy of BTX-A in Japanese @entity2182 @entity1 .
