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Botulinum Neurotoxin Type A Is Effective for Refractory Idiopathic Detrusor Overactivity Incontinence: Presented at ICS By Jill Stein SAN FRANCISCO -- October 2, 2009 -- Botulinum neurotoxin type A (BoNT/A) treatment is effective in roughly half of patients with refractory idiopathic detrusor overactivity incontinence at 1 month after treatment, according to data released here on October 1 at the 39th Annual Meeting of the International Continence Society (ICS). Shahid Khan, MBBS, MRCS, National Hospital for Neurology and Neurosurgery, London, and colleagues examined patient-reported continence rates after intradetrusor injections with 200 units of BoNT/A in 74 patients who were refractory to behavioural therapy and drug therapy for at least 3 months. “Objective measures of treatment efficacy, including urodynamic studies and bladder diary variables, do not accurately represent nor do they correlate with patient-reported outcomes,” explained Dr. Khan. Thus, validated subjective instruments are needed to assess how well OAB is managed. In this study, the primary outcome measure was the patient-reported outcome of complete continence, defined as a score of 0 on both the urgency and stress incontinence subscales of the Urogenital Distress Inventory at the fourth week after the first BoNT/A intradetrusor injection. Overall, 38 patients (51%), had complete continence 4 weeks after treatment. The study also found that patients in whom complete continence was not achieved had a significant reduction in urgency incontinence, stress incontinence, and urinary frequency. Importantly, the patients enrolled in this study reflect a diverse group of refractory patients with urinary incontinence and mixed incontinence, which is typical of routine clinical practice, Dr. Khan observed. Finally, he said that future studies will determine which BoNT/A dose has the best effect with the lowest rate of clean intermittent self-catheterisation. In Europe, about 17% of women and about 15% of men over 40 years of age have overactive bladder symptoms, Dr. Khan said. [Presentation title: Complete Continence After Botulinum Neurotoxin Type A Injections for Refractory Idiopathic Detrusor Overactivity Incontinence: Patient-Reported Outcome. Abstract 627] E-mail this page to a friend or colleague! To print, use this version