Définition et prise en charge de l'échec d'une première injection de toxine botulique Botox ® 200 U pour hyperactivité détrusorienne neurogène: résultats de l'enquête DETOX [Definition of botulinum toxin failure in neurogenic detrusor overactivity: Preliminary results of the DETOX survey].

Details

Serval ID
serval:BIB_1B83D58A8967
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Définition et prise en charge de l'échec d'une première injection de toxine botulique Botox ® 200 U pour hyperactivité détrusorienne neurogène: résultats de l'enquête DETOX [Definition of botulinum toxin failure in neurogenic detrusor overactivity: Preliminary results of the DETOX survey].
Journal
Progrès En Urologie
Author(s)
Peyronnet B., Sanson S., Amarenco G., Castel-Lacanal E., Chartier-Kastler E., Charvier K., Damphousse M., Denys P., de Seze M., Egon G., Even A., Forin V., Karsenty G., Kerdraon J., le Normand L., Loche C.M., Manunta A., Mouracade P., Phe V., Previnaire J.G., Ruffion A., Saussine C., Schurch B., Game X.
Working group(s)
Membres du GENULF (Groupe d'étude de neuro-urologie de langue française) et du comité de neuro-urologie de l'AFU (Association française d'urologie)
ISSN
1166-7087 (Print)
ISSN-L
1166-7087
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
25
Number
17
Pages
1219-1224
Language
french
Notes
Publication types: English Abstract ; Journal Article Publication Status: ppublish
Abstract
OBJECTIVE: There is currently no guideline regarding the management of neurogenic detrusor overactivity (NDO) refractory to intra-detrusor botulinum toxin injections. The primary objective of the present study was to find a consensus definition of failure of botulinum toxin intra-detrusor injections for NDO. The secondary objective was to report current trends in the managment of NDO refractory to botulinum toxin.
METHODS: A survey was created, based on data drawn from current literature, and sent via e-mail to all the experts form the Group for research in neurourology in french language (GENULF) and from the comittee of neurourology of the French urological association (AFU). The experts who did not answer to the first e-mail were contacted again twice. Main results from the survey are presented and expressed as numbers and proportions.
RESULTS: Out of the 42 experts contacted, 21 responded to the survey. Nineteen participants considered that the definition of failure should be a combination of clinical and urodynamics criteria. Among the urodynamics criteria, the persistence of a maximum detrusor pressure>40 cm H2O was the most supported by the experts (18/21, 85%). According to the vast majority of participants (19/21, 90.5%), the impact of injections on urinary incontinence should be included in the definition of failure. Regarding the management, most experts considered that the first line treatment in case of failure of a first intra-detrusor injection of Botox(®) 200 U should be a repeat injection of Botox(®) at a higher dosage (300 U) (15/20, 75%), regardless of the presence or not of urodynamics risk factors of upper tract damage (16/20, 80%).
CONCLUSION: This work has provided a first overview of the definition of failure of intra-detrusor injections of botulinum toxin in the management of NDO. For 90.5% of the experts involved, the definition of failure should be clinical and urodynamic and most participants (75%) considered that, in case of failure of a first injection of Botox(®) 200 U, repeat injection of Botox(®) 300 U should be the first line treatment.
Keywords
Administration, Intravesical, Botulinum Toxins, Type A/therapeutic use, Female, Humans, Male, Surveys and Questionnaires, Treatment Failure, Urinary Bladder, Overactive/drug therapy
Pubmed
Web of science
Create date
19/02/2016 18:53
Last modification date
20/08/2019 12:52
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