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872 CLINICAL RESPONSE TO INTRA-TRIGONAL ONABOTULINUM TOXIN A INJECTIONS IS NOT RELATED TO THE PRESENCE OF ULCERS IN BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS PATIENTS

2013; Lippincott Williams & Wilkins; Volume: 189; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2013.02.441

1527-3792

Rui Pinto, Tiago Lopes, João Silva, Carlos Silva, Paulo Dinis, Francisco Cruz,

Sexual function and dysfunction studies

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2013872 CLINICAL RESPONSE TO INTRA-TRIGONAL ONABOTULINUM TOXIN A INJECTIONS IS NOT RELATED TO THE PRESENCE OF ULCERS IN BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS PATIENTS Rui Pinto, Tiago Lopes, João Silva, Carlos Silva, Paulo DInis, and Francisco Cruz Rui PintoRui Pinto Porto, Portugal , Tiago LopesTiago Lopes Porto, Portugal , João SilvaJoão Silva Porto, Portugal , Carlos SilvaCarlos Silva Porto, Portugal , Paulo DInisPaulo DInis Porto, Portugal , and Francisco CruzFrancisco Cruz Porto, Portugal View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.441AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recently we showed that intra-trigonal Onabotulinum toxin A (OnaBotA) injection provides prolonged relief of bladder pain in Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) patients. Since injections were not performed in the ulcerative area, we investigated if the toxin provided a different symptomatic outcome and duration of effect in the two phenotypes of BPS/IC, the ulcerative and the non-ulcerative form. METHODS 10 ulcerative (Ulc) and 14 non-ulcerative (NUlc) BPS/IC patients were evaluated at presentation and 1 month after intra-trigonal injection of 100U of OnaBotA. A 10-point Visual Analogue Scale (VAS) was used to quantify pain. Frequency and nocturia in a 3-day voiding chart, O'Leary-Sant Score (OSS), QoL and duration of the effect were evaluated. Urinary norepinephrine was accessed by ELISA. RESULTS Patients had a mean age of 40±12 y in the Ulc and 47±13 y in the NUlc group (non-significant, ns). The ESSIC classification was 2a (3), 2b (5), 2c (6) in the NUlc group and 3a (1), 3b (3) and 3c (6) in the Ulc form group. Patients with the Ulc phenotype had a longer duration of symptoms (28.8±11 vs 19.2±8 months, p=0.018). Mean values at baseline of pain, frequency, nocturia, OSS, QoL were identical on the two groups. Likewise, the urinary norepinephrine was identical (Table 1). The two groups responded equally to OnaBotA with a marked decrease in pain, frequency, nocturia, OSS, QoL and in urinary norepinephrine levels (Table). The duration of the effect, 9±2.8 in the Ulc and 10.5±2 months in the NUlc disease was similar. CONCLUSIONS The symptom relief brought by trigonal OnabotA suggests that pain is not directly related with the ulcers themselves. We could not find symptomatic differences between those two phenotypes, challenging the traditional view that Ulc BPS/IC patients have a more symptomatic form of the disease. Ulcerative BPS/IC N=10 Non-ulcerative BPS/IC N=14 p After OnabotA Ulcerative BPS/IC N=10 After OnabotA Non-ulcerative BPS/IC N=14 p VAS 6.3 ± 0.9 5.6 ± 0.5 ns 2.9 ± 1.4 2.4 ± 1 ns Frequency 11.2 ± 2.4 10.3 ± 1.9 ns 7.9 ± 1 7.9 ± 0.9 ns Nocturia 5.9 ± 1 4.9 ± 0.5 ns 2 ± 1 1.9 ± 0.7 ns O'Leary-Sant Symptoms Score 16.6 ± 1 15.9 ± 0.8 ns 10 ± 2.4 8.7 ± 1.3 ns O'Leary-Sant Problems Score 12.8 ± 1 12.5 ± 0.7 ns 6.9 ± 1.2 6.6 ± 0.7 ns QoL (IPSS) 5.8 ± 0.4 5.9 ± 0.3 ns 2 ± 1.2 1.7 ± 1 ns Norepinephrine (24h-urine) 104.4 ± 38 100 ± 50.3 ns 77.2 ± 28 72.8 ± 31 ns © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e360 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rui Pinto Porto, Portugal More articles by this author Tiago Lopes Porto, Portugal More articles by this author João Silva Porto, Portugal More articles by this author Carlos Silva Porto, Portugal More articles by this author Paulo DInis Porto, Portugal More articles by this author Francisco Cruz Porto, Portugal More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...