September 2010
Kulaksizoglu H, Parman Y
Aim: To evaluate the efficacy of intravesical Botulinum toxin injection
for overactive bladder symptoms in patients with Parkinson's disease.
Materials and method: Parkinson's Disease patients with overactive
bladder symptoms and incontinence were included in the study. Patients
were interviewed using the SEAPI questionnaire. The caregivers evaluated
their decline in quality of life using the visual analog scale.
Intradetrusor injection technique with 30 point template was employed.
All patients received 500 i.u. of botulinum toxin-A. The follow-up was
at week one and every 12 weeks thereafter for 12 months. Primary
caregiver quality of life assessments were also performed using the VAS
scale in every visit.
Results: Sixteen patients were followed for 12
months. The mean age of the group was 67.2 +/- 5.1. Initial mean
functional bladder capacity for the group was 198.6 +/- 33.7 mL.In the
third month control the mean bladder capacity increased to 319 +/- 41.1
mL. The quality of life assessment of primary caregiver as well as the
patients also statistically improved after the injections (p < 0.05
for both). No neurological detoriation, confusion or disorientation were
noted. At the 9th month control 6 patients experienced some urgency
which they could suppress and were continent, 4 patients reported
occasional incontinence (once in 2-3 days) and 6 patients reported once
daily or more incontinence episodes. Medical therapy was prescribed for
12 patients and 4 asked for repeat injections.
Conclusion: Intravesical
botulinum toxin injection is an effective treatment modality with local
action and no central nervous system side effects in patients with
Parkinson's disease.
