There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
<div class="section">
<a class="named-anchor" id="S1">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d8715350e114">Purpose</h5>
<p id="P1">Published data regarding intradetrusor injection of onabotulinumtoxinA
in adults with
congenital spinal dysraphism are scarce. In this study, we retrospectively investigated
the outcomes of intradetrusor injection of onabotulinumtoxinA in this setting.
</p>
</div><div class="section">
<a class="named-anchor" id="S2">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d8715350e119">Materials and Methods</h5>
<p id="P2">Billing codes were used to identify 149 patients who underwent onabotulinumtoxinA
injection between 2012–2016 at our tertiary transitional urology clinic. Charts were
then reviewed to identify patients with congenital spinal dysraphism.
</p>
</div><div class="section">
<a class="named-anchor" id="S3">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d8715350e124">Results</h5>
<p id="P3">A total of 18 patients with the mean age of 20.76 (±3.03) years at the
time of 1st
onabotulinumtoxinA injection were identified. All patients had urinary incontinence.
Urinary incontinence improved by injection of 200 or 300 U of onabotulinumtoxinA in
81.2% of patients and 63.6% of them became dry (p= 0.023). Mean glomerular filtration
rate before and 13.3 (±9) months after treatment was 100.2 (±17.2) and 120.1 (±16.6)
mL/min/1.73 m2 respectively (p= 0.41). Baseline hydronephrosis improved in 3 of 4
patients. Repeat urodynamic study after injection was done in 11 patients who did
not clinically improve or who had loss of bladder compliance at baseline (29.3 Vs.
67.2 ml/cmH2O). Mean maximum cystometric capacity before and after injection was 310.1
and 380.2 mL (p= 0.045). Mean bladder compliance before and after treatment was 29.2
and 28.7 ml/cmH2O respectively (p= 0.48) in this high risk group.
</p>
</div><div class="section">
<a class="named-anchor" id="S4">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d8715350e129">Conclusions</h5>
<p id="P4">Intradetrusor onabotulinumtoxinA injection may improve refractory urinary
incontinence
in selected adults with spinal dysraphism. However, despite improvement in maximum
cystometric capacity, bladder compliance does not improve following therapy in patients
who had loss of compliance at baseline.
</p>
</div>