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Urge fecal incontinence: are intramural rectal injections of botulinum toxin a long-term treatment option?
Tech Coloproctol
December 2024
Service de Gastroentérologie, Hôpital NORD, Assistance Publique Hôpitaux de Marseille; Aix-Marseille Université, Marseille, France.
Background And Aims: Unsuccessful first-line conservative treatments for managing fecal incontinence (FI) lead to considering predominantly invasive options, posing challenges in terms of cost and patient acceptance of benefit/risk ratio. Recent data from a prospective randomized study have highlighted intramural rectal botulinum toxin (BoNT/A) injection as a promising minimally invasive alternative for urge FI, demonstrating efficacy at 3 months but lacking long-term evidence. This study aimed to evaluate the sustained efficacy and injection frequency of intramural rectal BoNT/A injection in the treatment of urge FI.
View Article and Find Full Text PDFFemale Pelvic Conditions: Urinary Incontinence.
FP Essent
December 2024
Menominee Tribal Clinic, Keshena, WI.
Urinary incontinence is the involuntary loss of urine. It is a prevalent and bothersome condition in females, with subtypes including stress, urge, mixed stress/urge, and overflow. Evaluation begins with a history to identify symptoms of the different subtypes and information about comorbid conditions, incontinence frequency and severity, and effect on quality of life.
View Article and Find Full Text PDFTrends in Overactive Bladder Therapy: Associations Between Clinical Care Pathways, Practice Guidelines, and Therapy Utilization Patterns.
Neurourol Urodyn
November 2024
Department of Urology, Stanford University, Stanford, California, USA.
Article Synopsis
- Overactive bladder (OAB) is a long-term condition affecting health and finances, and guidelines were created to improve its management, but the effectiveness of these guidelines remains unclear.
- A study analyzed data from a national health claims database (Optum) between 2013 and 2018 to evaluate trends in OAB treatment, focusing on medication and minimally invasive therapies post-2014 guideline updates.
- The research included over 1.8 million patients, revealing a significant increase in new OAB diagnoses (369%) and providing insights into therapy utilization patterns based on various demographic factors.
Third-Line Therapeutic Interventions for Non-Neurogenic Bladder Dysfunction in Children.
Curr Urol Rep
December 2024
Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH, U.S..
Purpose Of Review: The aim of this article is to review considerations and efficacy of third-line treatments for pediatric non-neurogenic bladder dysfunction, including Botulinum toxin A (BoTNA), Posterior Tibial Nerve Stimulation (PTNS), and Sacral Neuromodulation (SNM).
Recent Findings: Federal Drug Administration approval for use of beta-3-agonists in overactive detrusor activity in pediatric patients may provide an additional step prior to third-line therapies. New long-term data on pediatric SNM efficacy, complications, and revision rates will provide valuable information for counseling families.
[Botulinum toxin A for idiopathic overactive bladder in women].
Urologie
July 2024
Fachklinik für Urologie am Marienhospital Erwitte, Betriebsstätte der Dreifaltigkeits-Hospital gGmbH Lippstadt, Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Universität Münster, Von-Droste-Straße 14, 59597, Erwitte, Deutschland.
Following a description of the historic evolution of botulinum toxin A detrusor injections for neurogenic and nonneurogenic bladder overactivity, which was mainly driven by German-speaking countries, the terminological revolution of 2002 and the influence on design and outcomes of upcoming approval studies for the indication overactive bladder (OAB) are examined. OnabotulinumtoxinA (100 IU) for second-line treatment of OAB received European approval in 2013. Phase IV observational studies concerning therapeutic persistence and adherence with onabotulinumtoxinA are analyzed and compared with therapeutic alternatives.
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