Hypothesis / aims of study
Introduction:
Botulinum toxins is a neurotoxin produced by the anaerobic bacteria Clostridium botulinum, was first isolated by Van Ermengem (1). It has several types but type A the one with the best results regarding duration (1). The first usage of botulinum toxin A by Stohrer et al. was in 1999 and since that time it become one of the treatments for the neurogenic detrusor overactivity NDO (2’3). FDA approved one botulinum toxin A for the treatment of NDO in August 2011.
Despite the efficacy of BTX injection, It is known that the most adverse effect post BTX injection are urinary tract infection UTI and urinary retention (1’4) and one randomized trial comparing different doses of BTX found the rate of post-procedural UTI to be 34–48%, with the highest being in the 200-U dose group (5).
The prevalence of UTI after Botox injection is well known, but it’s unknown the effect of Botox injection on recurrent UTI patient. The paucity of the outcomes of Botox injection on NDO patients with recurrent UTI in the literature make the need for the review of the outcomes.
The aim of our study is to analyses the effect of intravesical Botox injection on recurrent UTIs patients either by increase or decrease.
Study design, materials and methods
Methods:
We conducted our prospective cohort all patients who received 200 or 300 U Botox intravesical injection .We included patients with neurogenic bladder with detrusor overactivity, recurrent UTI . All patients received culture specific antibiotic and underwent Botox injection when urine is clean. Patients files were reviewed for Diagnosis, VU reflux, hydronephrosis ,Urodynamic finding, dose of Botox used .Patients were followed for the incidence of UTI developed post Botox injection in the early 6 months post injection .
Interpretation of results
incidence of urinary tract infection decreased after botox injection in neurogenic overactive bladder patients with recurrent UTI, with improvement in urodynamic parameters.