| 原 文 |
題 目 |
Botulinum Toxin B is Not an Effective Treatment of Refractory Overactive Bladder |
| 作 者 |
Hirst GR, Watkins AJ, Guerrero K, Wareham K, Emery SJ, Jones DR, and Lucas MG. |
| 出 處 |
Urology 69 (2007) 69-73 |
| 出版日期 |
2007 |
| 評 論 |
肉毒桿菌有分A-G型共7型而A、B型已證實能治療多種疾病包括泌尿科之排尿障礙。最近A型肉毒桿菌治療逼尿肌過度活動的研究非常熱門, 其效果也讓學者肯定。此篇文章Hirst等人研究B型肉毒桿菌針對idiopathic detrusor overactivity (IDO) or neurogenic DO (NDO)的效果。25個病人中只有7個病人的症狀改善, 並且在短期內又復發。作者的結論是B型肉毒桿菌並不適用於治療逼尿肌過度活動。
|
| abstract |
OBJECTIVES: To determine the efficacy and safety of botulinum toxin-B (BTX-B) in two groups of patients with urodynamically proven idiopathic detrusor overactivity (IDO) or neurogenic DO (NDO) refractory to conservative treatment. METHODS: This was a nonrandomized, prospective study. We diluted 5000 U of BTX-B in 20 mL of normal saline and injected it at 20 sites around the bladder, avoiding the trigone. The data collected at recruitment and 10 and 26 weeks postoperatively included number of incontinent episodes, frequency, and nocturia, King''s Health Questionnaire score, and the urodynamic parameters of volume at the first overactive contraction and maximal cystometric capacity. RESULTS: A total of 25 patients were recruited, 20 with IDO and 5 with NDO. Only 7 patients, all with IDO, reported symptomatic improvement at the 10-week assessment. The symptoms had returned in these 7 patients at a median of 136 days (range 106 to 151) after injection. Of the remaining 20 patients, 16 (13 with IDO and 3 with NDO) thought an initial improvement had occurred but it had worn off or was wearing off by the first assessment. Two patients (both with NDO) reported no improvement. CONCLUSIONS: BTX-B had a limited duration of action, with most of its symptomatically beneficial effects wearing off by 10 weeks in most of our patients. The short duration of action for BTX-B suggests it is unlikely to gain widespread use in the treatment of DO.
|
