Urologie pro praxi 4/2016

Use of botulinum toxin in the treatment of urinary incontinence

Urinary incontinence in patients constitute a major health, psychological and social problem. Botulinum toxin is a substance which blocks the presynaptic release of acetylcholine. When applying to the bladder detrusor muscle leads to its reversible paralysis. Botulinum toxin can be used to treat urinary incontinence due to detrusor overactivity. Currently it is mainlyt used for the treatment of neurogenic detrusor overactivity. The therapeutical effect lasts 6–9 months, continence is restored in up to 80 % of patients. Treatment also has a significant impact on the improvement of urodynamic parameters such as increased cystometric capacity and decrease in detrusor pressure. According to existing experience the treatment may be repeated with same efficiency. In clinical practice it is also increasing expansit of the treatment of idiopathic detrusor overactivity. After treatment there is a decrease of episodes of urgent urinary incontinence by up to 59 %, 38 %, decrease of frequency by 29 %. The most common side effects include hematuria, urinary tract infection and the need for initiation of intermittent self-catheterization due to increased postmicturition volume.

Keywords: botulinum toxin, urinary incontinence, neurogenic detrusor overactivity, idiopathic detruzor overactivity.