Onabotulinumtoxina

ONABOTULINUMTOXINA If behavioral and anticholinergic therapies for overactive bladder (OAB) fail, treatment options are onabotulinumtoxinA (BTxA), sacral nerve stimulation (SNS) with InterStim® therapy or posterior tibial nerve stimulation. In 2000 Schurch et al published a study on the use of BTxA for the treatment of neurogenic detrusor overactivity. Soon afterwards, BTxA was also used for the treatment of idiopathic detrusor overactivity. BTxA is a protein produced by the anaerobic gram-positive bacteria clostridium botulinum. Injection of BTxA leads to temporary chemical denervation and reduced nerve cell activity in the injected tissue. Treatment with BTxA decreases detrusor pressure during the filling and voiding phases. Most published articles indicate that 100 to 300 units diluted in 10 to 30 ml of saline are injected via cystoscopy. The 10 to 30 injections are made at different sites in the bladder wall into the detrusor muscle. The minimally invasive procedure, performed with the patient under local or general anesthesia, takes 5 to 10 minutes.