| Abstract [eng] |
Objective: to conduct a literature review about overactive bladder treatment with botulinum toxin A injections in multiple sclerosis patients and to present a clinical case. Methods: review was conducted using PubMed search system. All relevant full text English language publications from 2017 to 2022 were identified, with data extracted for the role of botulinum toxin A in treatment of neurogenic bladder. The key phrases were: “botulinum toxin”, “overactive bladder”, “multiple sclerosis”, “neurogenic bladder dysfunction”. The “related article” function was used to widen the results. A clinical case related to the review is presented. Clinical case: female patient born in 1980, on 2018-09-11 consulted with frequency, urgency and incontinence by urologist. The patient was voiding in every hour during the daytime and had nocturia. Since 2001, she is treated for multiple sclerosis. According to the collected data, she was diagnosed with overactive (neurogenic) bladder and prescribed anticholinergic medications. As there was resistance to treatment, she underwent endovascular injections of botulinum toxin A 200 U on 2018-11-15. After surgery, reduction was noted in frequency, urgency. The effect lasted for 31 months. Following the recurrence of symptoms, repeated injections were performed on 2021-09-22. Full effect of treatment was achieved without side effects. Conclusion: botulinum toxin A injections are effective, minimally invasive treatment for overactive bladder in multiple sclerosis patients. After surgery, urinary disorders decrease, urodynamic parameters and quality of life improves. However, possible side effects must be addressed, and preventive measures must be taken. |
