SCOTTSDALE, AZ USA (UroToday.com) - The study objective was to determine if patients who had received previous pelvic XRT benefit from intra-detrusor BTA for symptomatic relief of voiding symptoms. This was a retrospective chart review of patients who received pelvic XRT in 2 academic medical centers. All patients were assessed with pre- and post-operative urodynamics, AUA Symptom Score (AUASS), and subjective improvement. Results were on 17 patients (male=16 male, female = 1) who had either prostate cancer (n=15 or rectal cancer (n=2), who received treatment with BTX-A, and who had refractory OAB symptoms associated with prior pelvic XRT.
Preoperative UDS on 16 patients indicated: normal compliance in 12 patients, a median capacity of 200ml (78–579 ml), DO in 9 patients, median detrusor pressure at maximal flow rate of 27mm H2O (13–95mm H2O), and complete emptying. Subjective improvement was seen in 76.5% of patients (13/17) with a median BTA dose of 100U (80–200U). The AUASS reduced from a mean of 21.6 to 13.4. Transient urinary retention requiring ISC was seen in 2 patients. Six patients had a second and one patient had a third BTX-A injection. Five patients had resolution of DO and symptoms and successful subsequent placement of an artificial urinary sphincter.
Before BTX-A can become a standard treatment in a post-XRT population, a prospective, larger study should be performed.
Presented by D. Flores, S. Mock, J. Broghammer, T. Griebling, R. Dmochowski, and P. Padmanabhan at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Winter Meeting - February 24 - 28, 2015 - JW Marriott Camelback Inn Resort & Spa - Scottsdale, AZ USA
Reported by Diane K. Newman, DNP, FAAN, BCB-PMD, medical writer for UroToday.com.