Botulinium toxin and idiopathic overactive bladder: Multicentric contempory management in Bourgogne

Introduction. - Since 2014, OnabotulinumtoxinA Botox (Allergan, Inc., Irvine, USA) represents a new therapeutic option for second-line treatment of idiopathic overactive bladder. The purpose of the current study was to evaluate practices of surgeons using onabotulinium toxin (BoNTA) in this indication. Material and methods. - All urogynecology centers of the country were asked in order to list all patients who were treated since marketing autorisation. Patient symptoms, previous treatments, paraclinic evaluations, data of surgery and the characteristics of the follow up were collected and analyzed. Results. - Six centers used BoNTA and five have accepted to participate. Ninety-seven patients have been identified. Sixty-eight first injections (70%) were carried out with the strict frameworf of the marketing autorisation (urinary frequency, urinary urgency, urinary incontinence). All patients had at least two symptoms. In 69%, Botulinum toxin was a second-line treatment after the failure of tibial neuromodulation or sacral neuromodulation. Urodynamic evaluation was carried out for 91% of patients. The search for a post-void residual volume was observed for 59% of patients during the follow up. Conclusion. - In our country, BoNTA injections for idiopathic overactive bladder are mainly effected after tibial neuromodulation or sacral neuromodulation failure. Diagnostic, operating and outcome evaluation practices are still very heterogeneous pleading for a greater standardization of this new therapy in this indication. (c) 2017 Elsevier Masson SAS. All rights reserved.