Allameh F, Hosseininia M, Karimi Rouzbahani A, Narouie B, Dadpour M. Efficacy of botulinum toxin-A injection versus oral anticholinergic medications following transurethral resection of the prostate to manage bladder outlet obstruction with overactive bladder: a prospective randomized clinical trial study.
Am J Clin Exp Urol 2023;
11:228-234. [PMID:
37441443 PMCID:
PMC10333132]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/22/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND
To compare the effect of botulinum toxin-A (BoNT-A) injection versus oral anticholinergic agents following transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and Overactive Bladder.
MATERIALS AND METHODS
In this randomized clinical trial from February 2021 till May 2022 data of patients with obstructive urinary symptoms and urgency incontinence were analyzed. The intervention group consisted of 35 patients who were injected with 300 units of BoNT-A (Dysport®) into the detrusor muscles at the same time as TURP. 38 participants in the control group were treated with solifenacin 5 mg (Urinacin®) daily after TURP.
RESULTS
In the evaluation of 73 included patients (mean age: 67.54±6.3), IPSS score change (first month, P=0.777; 6th month, P=0.761) and storage irritative symptoms change score (first month, P=0.995; 6th month, P=0.962) were decreased and Qmax was increased (first month, P=0.195; 6th month, P=0.174) similarly in 2 groups. Lower number of patients experienced urgency incontinence during follow up time in intervention group, significantly (first month, 18 versus 5, P=0.002; 6th month, 20 versus 6, P=0.002). PVR was also decreased more in first month and 6th month follow up in patients of intervention group (1th month, P=0.012; 6th month, P=0.033).
CONCLUSION
Anticholinergic agents or intradetrusor BoNT-A injection would improve the storage symptoms in patients with BPH and detrusor overactivity following TURP. In contrast to IPSS score, storage irritative score and Qmax, which improve similarly in both groups, the PVR and urgency incontinence episodes will improve more in patients receive intradetrusor BoNT-A injection.
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