Six years followup of botulinum A toxin intradetrusorial injections in patients with refractory neurogenic detrusor overactivity: clinical and urodynamic results.

INTRODUCTION AND OBJECTIVE: We investigated the effectiveness and safety of botulinum-A toxin (BONT/A)injections into the detrusor muscle in a group of spinal cord injured (SCI) patients with detrusor overactivity unresponsive to conventional anticholinergics, who reached a follow up longer than 6 years. METHODS: Since October 2000, 83 patients with refractory neurogenic and non-neurogenic detrusor overactivity, bladder hypersensitive disorders and BPH have been treated at our institution with intravesical BoNT/A. Among them, 17 SCI patients reached a follow up longer than 6 years and received multiple treatments along time. We reviewed clinical evaluations, voiding charts, frequency of urinary tract infections-UTI, imaging assessment of the upper urinary tract (UUT), and urodynamics, as well as patients’ drop out and satisfaction. CONCLUSIONS: Intravesical BoNT/A represents a valuable treatment for refractory neurogenic detrusor overactivity over a long clinical term follow up.