Intravesical Botox for overactive bladder; how to minimize complications and manage failures.

Intravesical Botox for overactive bladder; how to minimize complications and manage failures. Curr Drug Targets. 2020 Jun 21;: Authors: Apostolidis A, Papaefstathiou E, Gatsos S Abstract Intravesical Botox has become a widespread treatment for patients with refractory overactive bladder. Further to its acknowledged efficacy, both physicians and patients must be fully aware of possible complications, such as urinary tract infections, incomplete bladder emptying or even urinary retention and possible need for intermittent selfcatheterizations, fatigue, muscle weakness, transient hematuria and autonomic dysreflexia. Careful patient selection, particularly in terms of comorbidities, caution with technical aspects of the procedure such as the use of fine specifically designed injection needles, treatment of baseline UTIs or bacteriuria, avoidance of bladder overfilling could be the main measures, in addition to rigorous patient follow-up, to minimize the risk of post-Botox UTIs, hematuria, autonomic dysreflexia, and retention. Management of Botox failures is currently an unchartered area, starting with the definition of failure per se. Nevertheless, dose increase, particularly in neurogenic patients, increase of treatment frequency, switch to abobotulinumtoxinA, prolongation of injection intervals with add-on oral therapy, use of percutaneous tibial nerve stimulation or sacral neuromodulation and alleviation of risk factors for failure su...
Source: Current Drug Targets - Category: Drugs & Pharmacology Authors: Tags: Curr Drug Targets Source Type: research