The Efficacy and Safety of Intradetrusor Botulinum Toxin Injection in Urinary Incontinence in Geriatric Patients

INTRODUCTION: Antimuscarinic agents play an important function in the treatment of urinary incontinence. Intradetrussor onabotulinum toxin (Btx-A) injection is recommended if antimuscarinic drugs fail. This study examined Btx-A injection efficacy and adverse effects by age.
METHODS: The study has 54 patients who did not respond or tolerate two antimuscarinic drugs were injected with Btx-A. Before operation, urodynamics, voiding diary, International Consultation Incontinence Questionnaire Short-Form (ICIQ-SF) and Incontinence Quality of Life (IQoL) were assessed. Six weeks after operation, these values were repeated. In light of these findings, the treatment efficacy of the Btx-A injection was assessed. A two-way ANOVA test was performed for repeated measurements.
RESULTS: The study included 54 patients, 37 female and 17 male. Twenty patients were 65 or older, 34 were under 65. Most patient groups benefited from Btx-A injections.
Age doesn't affect Btx-A injection effectiveness. In 54 patients, maximal bladder capacity increased 50%, maximum detrusor pressure decreased 42%, incontinence quality of life score increased 71%, and average daily incontinence decreased 69%. Nine patients (16%) had urinary tract infections and one had urine retention (1.8%).

DISCUSSION AND CONCLUSION: IntradetrussorBtx-A injections should be favored due to their adequate efficacy and low incidence of side effects. Injection of intradetrussorBtx-A is a reliable, tolerable, reproducible, and effective invasive treatment for resistant urinary incontinence or overactive bladder.
Considering the adverse effects of antimuscarinic agents in OAB patients 65 and older who are resistant, Btx-A injection should be recommended due to its low rate of complications and efficacy.