Use of botulinim toxin-A for the treatment of overactive bladder symptoms in patients with Parkinsons's disease.

AIM: To evaluate the efficacy of intravesical Botulinum toxin injection for overactive bladder symptoms in patients with Parkinson's disease.

MATERIALS AND METHOD: Parkinson's Disease patients with overactive bladder symptoms and incontinence were included in the study. Patients were interviewed using the SEAPI questionnaire. The caregivers evaluated their decline in quality of life using the visual analog scale. Intradetrusor injection technique with 30 point template was employed. All patients received 500 i.u. of botulinum toxin-A. The follow-up was at week one and every 12 weeks thereafter for 12 months. Primary caregiver quality of life assessments were also performed using the VAS scale in every visit.

RESULTS: Sixteen patients were followed for 12 months. The mean age of the group was 67.2 +/- 5.1. Initial mean functional bladder capacity for the group was 198.6 +/- 33.7 mL.In the third month control the mean bladder capacity increased to 319 +/- 41.1 mL. The quality of life assessment of primary caregiver as well as the patients also statistically improved after the injections (p < 0.05 for both). No neurological detoriation, confusion or disorientation were noted. At the 9th month control 6 patients experienced some urgency which they could suppress and were continent, 4 patients reported occasional incontinence (once in 2-3 days) and 6 patients reported once daily or more incontinence episodes. Medical therapy was prescribed for 12 patients and 4 asked for repeat injections.

CONCLUSION: Intravesical botulinum toxin injection is an effective treatment modality with local action and no central nervous system side effects in patients with Parkinson's disease.