Intravesical Injection with Abobotulinumtoxin-A in Patients with Bladder Pain Syndrome/Interstitial Cystitis

Abstract

In the United States, it is estimated that about 6.5% or eight million women aged 18 years could be diagnosed as BPS/IC. Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a persistent or recurrent chronic pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptom such as an urgent need to void or urinary frequency. The severity of these symptoms may vary from person to person depending on the progress of the disease. Painful bladder syndrome can affect the quality of life due to the symptoms and complications it causes. Botulinum toxin A is a powerful neurotoxin produced by Clostridium botulinum bacteria. Recent studies have shown that Botox injection can reduce inflammation, thus improving the protective function of the urothelium in patients. In recent decades, several modalities have been established for the treatment of painful bladder syndrome, but the therapeutic results of these methods are still controversial. Although previous studies have shown the promising efficacy of botox single dose injection in the treatment of painful bladder syndrome,Long-term effects have not had successful results Considering that so far limited studies have studied the effect of botulinum toxin A (Dysport) injection on painful bladder syndrome and its long-term results, the present study aims to investigate the effects of Dysport (Abobotulinumtoxin-A) injection on patients with painful bladder syndrome/Interstitial cystitis. Methods: The research method was that after approving the proposal and obtaining the code of ethics from the respected regional ethics committee, the

researcher listed all patients with painful bladder syndrome/interstitial cystitis who were resistant to first and second line treatment and between the years 2014 and 2015 had been injected and had the Bladder Pain/Interstitial Cystitis Symptom Score (BPIC-SS) questionnaire before and after the injection completed by the specialist in the case. Based on the checklist, the patient's satisfaction with the operation is measured from completely satisfied to completely dissatisfied (completely satisfied, somewhat satisfied, dissatisfied, completely dissatisfied). It should be noted that an informed consent form is obtained from all patients before injection. Result: 52% of patients showed improvement during treatment (moderate satisfaction) and 41% responded well to treatment (high satisfaction). Only three patients (7%) had no response to the treatment (low satisfaction). We analyzed the different parts of the BPIC-SS questionnaire and all the parts improved after the injection. 41 of the participants were women and 3 were men. The average age of the studied population was 57 years. The average duration of the disease was 27 months (with the lowest value of 6 months and the highest value of 120 months). The average follow-up time of the patients was 9 months (range 3-48 months). Adverse effects were seen in 4 patients, one of whom had a persistent urinary tract infection, and three of them had urinary excretion disorders.