Titre
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].
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Peyronnet, B.
Auteure/Auteur
Sanson, S.
Auteure/Auteur
Amarenco, G.
Auteure/Auteur
Castel-Lacanal, E.
Auteure/Auteur
Chartier-Kastler, E.
Auteure/Auteur
Charvier, K.
Auteure/Auteur
Damphousse, M.
Auteure/Auteur
Denys, P.
Auteure/Auteur
de Seze, M.
Auteure/Auteur
Egon, G.
Auteure/Auteur
Even, A.
Auteure/Auteur
Forin, V.
Auteure/Auteur
Karsenty, G.
Auteure/Auteur
Kerdraon, J.
Auteure/Auteur
le Normand, L.
Auteure/Auteur
Loche, C.M.
Auteure/Auteur
Manunta, A.
Auteure/Auteur
Mouracade, P.
Auteure/Auteur
Phe, V.
Auteure/Auteur
Previnaire, J.G.
Auteure/Auteur
Ruffion, A.
Auteure/Auteur
Saussine, C.
Auteure/Auteur
Schurch, B.
Auteure/Auteur
Game, X.
Auteure/Auteur
Groupes de travail
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)
Liens vers les personnes
Liens vers les unités
ISSN
1166-7087
Statut éditorial
Publié
Date de publication
2015
Volume
25
Numéro
17
Première page
1219
Dernière page/numéro d’article
1224
Peer-reviewed
Oui
Langue
français
Notes
Publication types: English Abstract ; Journal Article Publication Status: ppublish
Résumé
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.
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.
PID Serval
serval:BIB_1B83D58A8967
PMID
Date de création
2016-02-19T17:53:51.454Z
Date de création dans IRIS
2025-05-20T18:37:15Z