Toxina botulínica intradetrusor: resultados e impacto en la frecuentación asistencial en pacientes con vejiga hiperactiva

Background: according to EUA and AUA guidelines, intradetrusor botulinum toxin A (TxBA) is a first-line alternative in cases of therapeutic failure, contraindications, intolerance to medication due to adverse effects, or refusal of conservative treatment for overactive bladder (OAB). Objective: to assess the impact on visit frequency and the clinical and urodynamic characteristics of patients over 18 years of age undergoing intradetrusor botulinum toxin application in a functional urology service in Barcelona, Spain. Patients and methods: descriptive, retrospective, observational study analyzing the medical records of patients undergoing botulinum toxin application, with a 2-year follow-up. Medical records were reviewed, and follow-up calls were made to all patients. Prior informed consent were signed, the medical records were reviewed, and follow-up calls were made to all patients. Descriptive and inferential statistics were used, statistical significance p value < 0.05. Results: total of 23 non-neurogenic patients were studied, 62.5 % (15) women and 34.8 % (8) men, with a mean age of 63.52 ± 3.3 years. Prior to the application of TxBA, 78.3 % (18) had received anticholinergic treatment, and 47.8 % (11) had been treated with Mirabegron. The mean number of medical visits per year before TxBA was 4.0. Pre-TxBA evaluations showed a mean bladder capacity of 110.2 ± 25 ml, a daytime voiding frequency of 1.7 hours, and 2.86 nocturnal episodes per night. After a mean follow-up period of 12.21 months post-TxBA application, medical visits were reduced to 2.24 visits per year (p = 0.001). Symptomatic assessment revealed an increase in mean daytime voiding frequency to 2.8 ± 0.7 hours, accompanied by a decrease in nocturnal episodes to 1.9 ± 0.8 per night, both showing statistically significant reductions (p=0.001) Conclusion: the application of intradetrusor botulinum toxin leads to a reduction in visit frequency in patients with overactive bladder. It is a safe procedure with few complications and symptom improvement.