Quality of Life in Neurogenic Bladder Patients and Improvement after Botulinum Toxin Injection

Abstract

Various neurogenic conditions may determine an altered function of the bladder and urethral sphincters leading to urinary symptoms. Among these symptoms, loss of urine is considered the most bothersome, and recent literature has proposed that urinary incontinence and poor quality of life should be considered as associated conditions. Urinary incontinence is responsible for reducing the enjoyment of life, including loss of self-confidence and limitation of social activity; it is also associated with anxiety, depression, and deterioration in sexual life, and reduced physical activity. Conservative treatments represent a first-line therapeutic approach to neurogenic urinary disorders, followed by oral medications. However, these treatments often do not provide complete recovery from symptoms, especially from urinary incontinence. Onabotulimun toxin A has proven to be safe and effective for treating neurogenic urinary incontinence and its use is associated with a strong improvement of patients’ quality of life. Furthermore, this treatment lowers the risk of severe complications to the upper urinary tract, reducing the need for hospitalization. Quality of life improvement as well as clinical efficacy must be considered targets of the therapy, and the use of onabotulimun toxin A for treating neurogenic urinary incontinence reaches both these goals.