William Chui, Alvaro Bazo, Henry H. Yao, Joshua Kealey, Lana Pepdjonovic, Helen E. O'Connell, Johan Gani, Richard Parkinson
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Duration of effect was time (months) between BoNT injection to patient reported onset of symptom recurrence. Data on BoNT type and dosing, urinary tract infection (UTI), urinary retention, ICIQ-OAB and International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ-UI) questionnaires were also collected. Statistical analyses were conducted with SPSS® 25 software. <i>P</i>-value < 0.05 was considered statistically significant.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>There were 943 patients stratified into age groups: < 40 (183), 40–49 (150), 50–59 (173), 60–69 (219) and ≥ 70 (218). Median age was 58 (IQR 44–69). Most patients were female 724/943 (76.8%). From Cycles 1 to 4, age group ≥ 70 efficacy rates were 85.1%, 84.1%, 92.6% and 89.3%. Corresponding median duration of effect (months) were 6.8, 8.0, 7.0 and 8.0. For Cycle 2; age ≥ 70 was a predictor of reduced efficacy (<i>P</i> = 0.004). Neurogenic causes of OAB were predictors of increased efficacy for Cycles 2 (<i>P</i> = 0.004) and 3 (<i>P</i> = 0.0145). Men had higher rates of urinary retention than women in Cycles 1 (42.4% vs 29.3%, <i>P</i> = 0.003) and 2 (37.9% vs 23.0%, <i>P</i> = 0.0018). All age groups showed improvement in patient-reported outcome measures (PROMs) post-BoNT injection.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In elderly patients with refractory OAB and treated with intradetrusor BoNT (up to four cycles), age ≥ 70 was an independent predictor for reduced BoNT efficacy (84.1%) in Cycle 2.</p>\n </section>\n </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70048","citationCount":"0","resultStr":"{\"title\":\"The use of intradetrusor botulinum toxin in the geriatric population\",\"authors\":\"William Chui, Alvaro Bazo, Henry H. Yao, Joshua Kealey, Lana Pepdjonovic, Helen E. 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Data on BoNT type and dosing, urinary tract infection (UTI), urinary retention, ICIQ-OAB and International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ-UI) questionnaires were also collected. Statistical analyses were conducted with SPSS® 25 software. <i>P</i>-value < 0.05 was considered statistically significant.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>There were 943 patients stratified into age groups: < 40 (183), 40–49 (150), 50–59 (173), 60–69 (219) and ≥ 70 (218). Median age was 58 (IQR 44–69). Most patients were female 724/943 (76.8%). From Cycles 1 to 4, age group ≥ 70 efficacy rates were 85.1%, 84.1%, 92.6% and 89.3%. Corresponding median duration of effect (months) were 6.8, 8.0, 7.0 and 8.0. For Cycle 2; age ≥ 70 was a predictor of reduced efficacy (<i>P</i> = 0.004). Neurogenic causes of OAB were predictors of increased efficacy for Cycles 2 (<i>P</i> = 0.004) and 3 (<i>P</i> = 0.0145). 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引用次数: 0
摘要
本研究旨在探讨年龄对难治性膀胱过度活动综合征（OAB）老年患者肌内肉毒毒素（BoNT）使用（长达4个周期）相关长期预后的影响。材料和方法我们在诺丁汉（英国）和墨尔本（澳大利亚）进行了一项回顾性观察队列研究。2005年1月至2020年1月间接受肌内BoNT治疗的难治性OAB患者分为年龄≤40岁、40 - 49岁、50-59岁、60-69岁和≥70岁。疗效定义为患者自我报告的bont注射后症状的改善。效果持续时间为BoNT注射到患者报告症状复发之间的时间（月）。还收集了BoNT类型和剂量、尿路感染（UTI）、尿潴留、ICIQ-OAB和国际尿失禁咨询问卷（ICIQ-UI）调查问卷的数据。采用SPSS®25软件进行统计学分析。p值<； 0.05认为有统计学意义。结果943例患者分为年龄组：<；40（183）、40 - 49（150）、50-59（173）、60-69（219）和≥70（218）。中位年龄58岁（IQR 44-69）。女性占724/943例（76.8%）。周期1 ~ 4，≥70岁年龄组有效率分别为85.1%、84.1%、92.6%和89.3%。相应的中位有效时间（月）分别为6.8、8.0、7.0和8.0。对于循环2；年龄≥70岁是疗效降低的预测因子（P = 0.004）。OAB的神经源性原因是第2周期（P = 0.004）和第3周期（P = 0.0145）疗效增加的预测因素。男性在第1周期（42.4% vs 29.3%, P = 0.003）和第2周期（37.9% vs 23.0%, P = 0.0018）的尿潴留率高于女性。注射bont后，所有年龄组的患者报告结果测量（PROMs）均有改善。结论：在接受肌内BoNT治疗的老年难治性OAB患者（最多4个周期）中，年龄≥70岁是第2周期BoNT疗效降低（84.1%）的独立预测因子。
The use of intradetrusor botulinum toxin in the geriatric population
Objectives
This study aims to explore the impact of age on long-term outcomes associated with intradetrusor botulinum toxin (BoNT) usage (up to four cycles) in elderly patients with refractory overactive bladder syndrome (OAB).
Materials and Methods
We conducted a retrospective observational cohort study across institutions in Nottingham (UK) and Melbourne (Australia). Patients with refractory OAB and treated with intradetrusor BoNT between January 2005 and January 2020 were stratified into age groups: ≤40, 40–49, 50–59, 60–69 and ≥70 years. Efficacy was defined as patient self-reported improvement in symptoms post-BoNT injection. Duration of effect was time (months) between BoNT injection to patient reported onset of symptom recurrence. Data on BoNT type and dosing, urinary tract infection (UTI), urinary retention, ICIQ-OAB and International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ-UI) questionnaires were also collected. Statistical analyses were conducted with SPSS® 25 software. P-value < 0.05 was considered statistically significant.
Results
There were 943 patients stratified into age groups: < 40 (183), 40–49 (150), 50–59 (173), 60–69 (219) and ≥ 70 (218). Median age was 58 (IQR 44–69). Most patients were female 724/943 (76.8%). From Cycles 1 to 4, age group ≥ 70 efficacy rates were 85.1%, 84.1%, 92.6% and 89.3%. Corresponding median duration of effect (months) were 6.8, 8.0, 7.0 and 8.0. For Cycle 2; age ≥ 70 was a predictor of reduced efficacy (P = 0.004). Neurogenic causes of OAB were predictors of increased efficacy for Cycles 2 (P = 0.004) and 3 (P = 0.0145). Men had higher rates of urinary retention than women in Cycles 1 (42.4% vs 29.3%, P = 0.003) and 2 (37.9% vs 23.0%, P = 0.0018). All age groups showed improvement in patient-reported outcome measures (PROMs) post-BoNT injection.
Conclusion
In elderly patients with refractory OAB and treated with intradetrusor BoNT (up to four cycles), age ≥ 70 was an independent predictor for reduced BoNT efficacy (84.1%) in Cycle 2.
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