Botulinum Toxin Type A in Neurogenic Overactive Bladder Dysfunction in Patients with Multiple Sclerosis

Villalba Bachur Roberto F*, Kohan Diego F, Fernandez C. Gaston, Angeloni Guido, Koren Claudio A, Longo Emilio M

Botulinum Toxin Type A in Neurogenic Overactive Bladder Dysfunction in Patients with Multiple Sclerosis.

Multiple sclerosis is the most common progressive neurological disorder of young people. The average age of start is 30-years-old and a prevalence of 108 cases per 100.000 people in Europe. It has a progressive course and there are four types of MS. The relapsing-remitting is the most reported, in about 85%. There are a lot of different symptoms consequence of the central nervous system demyelination and the subsequent altered nerve conduction.

The presence of urinary symptoms is really frequent with a prevalence of 37-99% for OAB syndrome, characterized by storage symptoms. For voiding symptoms the prevalence is 34-79% and for chronic urinary retention is 25%. Women are affected twice as commonly as men; however, men usually have a worse clinical presentation. The most frequent voiding disorder is spastic bladder and neurogenic detrusor overactivity

The International Continence Society define the OAB Syndrome as urinary urgency, usually with an increase of frequency and nocturia, with or without urinary incontinence. Urological involvement can condition the long-term prognosis of the disease due to the development of infections and renal complications.

Thus, the correct diagnosis and treatment in these patients can provide greater control of the disease as well as, provide a better quality of life. The standard treatment of patients with overactive detrusor are the antimuscarinics drugs, which act blocking parasympathetic nerve impulses to the detrusor muscle, making it relax and thereby improving bladder capacity. Beta-3 adrenergic drugs are also prescribed for these patients.

Urol Androl Open J. 2021; 5(1): 10-14. doi: 10.17140/UAOJ-5-138