A comparative observational study to evaluate the efficacy of mid-urethral sling with botulinum toxin a injection in urinary incontinence patients

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Abstract

This study aimed to evaluate and compare the efficacy and safety of mid-urethral sling (MUS) with botulinum toxinA(BoNT-A) versusMUSonly in women with mixed urinary incontinence. This was a comparative observational study, and total of 73 patients were enrolled. A total of 38 and 35 patients received MUS only and MUS with BoNT-A injection, respectively. The efficacy outcome included change in Urinary Incontinence Outcome Scores (UIOS), change in Overactive Bladder Symptom Score (OABSS), and use of antimuscarinic agent or beta-3 agonist. Safety assessments included adverse events including urinary retention, increased postvoid residual volumes, and urinary tract infection. MUS with BoNT-A injection was insignificantly better than MUS only in urinary incontinence outcome (88% vs. 71%, respectively, p = 0.085) at week three. Among the 33 patients with detrusor overactivity (DO), patients who received BoNT-A had a higher cure rate of incontinence (88% vs. 41%, p = 0.01) and less required antimuscarinic agent or beta-3 agonist (31% vs. 94%, p < 0.001) compared to patients who did not receive BoNT-A injection. There was no significant difference in the incidences of adverse events between two groups. BoNT-A injection with MUS demonstrated efficacy and safety in the treatment of mixed urinary incontinence, specifically for women with DO.

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Chang, Y. H., Hsiao, P. J., Chi-Ping, H., Wu, H. C., Hsieh, P. F., & Chou, E. C. L. (2020). A comparative observational study to evaluate the efficacy of mid-urethral sling with botulinum toxin a injection in urinary incontinence patients. Toxins, 12(6). https://doi.org/10.3390/toxins12060365

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