Table 3.
Clinical results of intravesical botulinum toxin injections.
| Clinical results | |||||
|---|---|---|---|---|---|
| Article | Follow-up | First injection | Reinjections | Postoperative urodynamics first injection | Adverse effects |
| Hoebeke et al.[12] (2006) | 12 mo | 6 mo: full response 60%, partial 20%, no response 20% 12 mo: full response 53.3% |
Full response 50% and partial 50% | Most patients refused to perform invasive urodynamics. No differences in uroflowmetry except voided volume; temporary dysfunctional voiding 4.7% |
10-d urinary retention (4.7%), presumable temporary vesicoureteral reflux (4.7%), UTI (9.5%) |
| Lahdes-Vasama et al.[13] (2011) | 12 mo | 1–3 mo: full/partial response 92% 6 mo: full/partial response 90% 12 mo: full/partial response 55% |
1–3 mo: 100% positive response 6–12 mo: 86% positive response |
First injection, 6 wk: 67% increase of maximal cystometric capacity and significant decrease of high pressure bladder contractions | UTI (7.7%) |
| Blackburn et al.[10] (2013) | 5 mo | 5 mo: full response 44%, 37% improved frequency, 26% improved nocturia, and 26% improved urgency | - | - | 2 mo urinary retention (3.7%), UTI (26%), pain (3.7%) |
| Léon et al.[5] (2014) | 18 mo | 3 mo: decrease in incontinence episodes and night time incontinence 12 mo: full response 62% 18 mo: 25% reappearance of symptoms |
- | 2 mo: DO disappeared after 1 injection in 75% and decreased in amplitude in the remaining 25% 12 mo: compliance and bladder’s functional capacity improved in 100% 18 mo: reappearance of DO (25%) |
Temporary macroscopic hematuria |
| Bayrak et al.[11] (2017) | 9 mo | 9 mo: full response 54.5%; decrease in voiding frequency, incontinence episodes, number of pads used; nocturia disappeared 15% | 9 mo: no improvement or relapse 100% | First injection, 9 mo: no PVRU volume, mean bladder capacity increased, no significant difference in Qmax. Vesicouretheric reflux decreased in 9%, resolved in 15.2%, and was no change in 6% | Macroscopic hematuria (6%), UTI (18.1%) |
| Uçar et al.[6] (2018) | 12 mo | 6 mo: complete response 32.2%, partial 48.4%, and no response 19.4% 12 mo: complete response 61.3%, partial 29%; no response, 9.7% | 6 mo: complete response 42.9%, partial 42.5%, and no response, 14.3% | - | Hematuria 1–3 d (11.5%), UTI (5.7%) and transient urinary retention, 3-wk clean intermittent catheterization (1.9%) |
| Al Edwan et al.[4] (2019) | 3 mo | 3 mo: improvement in urge incontinence episodes of 57%, in enuresis of 56% and frequency in 38%. Improvement in quality of life. Great improvement in 54% of the patients and improvement, in 30% | - | 3 mo: significant improvement in cystometric capacity (increase of 26%). Mean Pdet max decreased by 44% and mean compliance increased by 126%, Complete resolution of DO in 67% of patients | Transient urinary retention (4.4%) < 4 wk, transient hematuria |
| Peeraully et al.[7] (2019) | 25 mo | Group 2: full response 47.8%, moderate 39.1%, no response 13%; median of improvement 6.5 mo | Full response 21.7%, moderate 8.7%, and no response 4.3%; median of improvement 9.5 mo | - | No adverse effects in nonneurogenic group; globally, only 6% (transient difficulties initiating miction, abdominal and penile pain) |
DO = detrusor overactivity; Pdet = detrusor pressure; Qmax = maximum urinary flow rate; UTI = urinary tract infection; PVRU = postvoid residual urine.