What are the possible adverse effects of botulinum toxin injections to treat neurogenic detrusor overactivity?

Updated: Mar 06, 2019
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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In 3 randomized, controlled trials, the most common adverse event (AE) of intradetrusor injection of botulinum toxin A was increased postvoid residual, which may necessitate clean intermittent catheterization. Thus, patients should be counseled about the potential need for clean intermittent self-catheterization (CIC).

A placebo-controlled study reported that the overall incidence of least 1 AE in treated patients was not significantly different from that in the placebo group. [4] The more frequently reported AEs across the studies were urinary tract infection and mild hematuria.

A dose-ranging study including both neurogenic detrusor overactivity (NDO) and idiopathic detrusor overactivity (IDO) patients reported that patients who received 100 U of botulinum toxin A had a significantly smaller postvoid residual urine volume than patients who received 150 U or 100 U at 1 month. [2] One study reported a mild case of asthenia after injection of botulinum toxin A 300 U, which persisted for 10 days. [5]

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