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International Urogynecology Journal

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01-12-2020 | Botulinum Toxin | Original Article

Obstructive patterns in videourodynamic studies predict responses of female dysfunctional voiding treated with or without urethral botulinum toxin injection: a long-term follow-up study

Authors: Po-Ming Chow, Sheng-Mou Hsiao, Hann-Chorng Kuo

Published in: International Urogynecology Journal | Issue 12/2020

Abstract

Introduction and hypothesis

We report long-term changes in VUDS profiles of women with dysfunctional voiding and investigate potential predictors for treatment response.

Methods

Women with dysfunctional voiding and available VUDS data between November 1997 and June 2018 were enrolled for retrospective analysis. The patients were all treated with medication first. In refractory patients, urethral botulinum toxin was provided as an additional option. The primary outcome was the change of VUDS parameters between baseline and follow-up studies. The secondary outcomes were baseline parameters and clinical factors that were associated with the BOOI response (> 10 points of BOOI reduction).

Results

A total of 195 women with DV were included in this study. The mean age was 54.5 years old. Sixty patients received urethral botulinum toxin injection. For all patients, Pdet decreased from 47.2 to 36.8 cm H₂O (p < 0.0001), and BOOI decreased from 26.4 to 17.7 (p = 0.0001). Patients with urethral injection had significantly smaller Qmax, voided volume, and voiding efficiency (VE) and significantly larger PVR and BOOI at baseline, indicating a severer obstruction in this group. The overall BOOI response rate was 44% (85/195). A higher baseline BOOI was associated with the BOOI response in multivariate analysis.

Conclusions

In this long-term study of women with dysfunctional voiding, medical treatment with or without urethral botulinum toxin injection both resulted in reduction of Pdet and BOOI. A more prominent obstructive profile at baseline VUDS study was associated with a higher rate of BOOI response at follow-up study.

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Title: Obstructive patterns in videourodynamic studies predict responses of female dysfunctional voiding treated with or without urethral botulinum toxin injection: a long-term follow-up study
Authors: Po-Ming Chow
Sheng-Mou Hsiao
Hann-Chorng Kuo
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keyword: Botulinum Toxin
Published in: International Urogynecology Journal / Issue 12/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04333-1

At a glance: The STEP trials

Springer Medicine

Obstructive patterns in videourodynamic studies predict responses of female dysfunctional voiding treated with or without urethral botulinum toxin injection: a long-term follow-up study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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