MP80-13 INTRAVESICAL ONABOTULINUMTOXIN A FOR BLADDER DYSFUNCTION IN “REAL WORLD” CLINICAL PRACTICE
Notice bibliographique
Résumé
You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Neurogenic Voiding Dysfunction1 Apr 2014MP80-13 INTRAVESICAL ONABOTULINUMTOXIN A FOR BLADDER DYSFUNCTION IN “REAL WORLD” CLINICAL PRACTICE Richard Baverstock, Bryce Weber, Trafford Crump, Daniel Yanko, and Kevin Carlson Richard BaverstockRichard Baverstock More articles by this author , Bryce WeberBryce Weber More articles by this author , Trafford CrumpTrafford Crump More articles by this author , Daniel YankoDaniel Yanko More articles by this author , and Kevin CarlsonKevin Carlson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2536AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Intravesical BOTOX (Onabotulinumtoxin A, BTA) injections for lower urinary tract dysfunction was first described in 1987, and has been used at our institution since 2004. It was approved for use in North America for refractory neurogenic detrusor overactivity (NDO) in 2012, and for idiopathic detrusor overactivity (IDO) in Canada in October 2013. BTA remains off-label for refractory bladder pain syndrome (BPS). Few studies have been published to confirm the long-term safety and efficacy of intravesical BTA, nor the adherence to this form of treatment. We report our long-term “real-world” clinical experience with BTA for refractory bladder storage dysfunction (NDO, IDO, BPS) in our high-volume institution, with attention to baseline data, growth in uptake, and persistence with therapy. METHODS A retrospective chart review of all patients injected between July 20, 2009 (when charts became available via EMR) and October 30, 2013 was performed. RESULTS Overall a total of 1265 injections were performed on 443 unique patients with mean age of 56 years (19 – 88). The majority of patients (66%) were injected under local anesthesia only. The number of BTA treatments ranged from 1 – 14. 63% of patients have received more than 1 injection while 41% have received 3 or more, and 14% 6 or more. Overall, 43% discontinued BTA at any time due to attrition, lack of effect, or change in bladder management. In 2010, 207 injections (17/month) were performed, while 270 were done in 2011 (23/month), and 330 in 2012 (28/month). In the first 10 months of 2013, 377 injections have been performed (38/month). Indications included NDO in 55%, IDO in 40%, BPS in 5%. For the NDO group, 65% were female, compared to 86% of the IDO and 100% of the BPS groups. In the NDO group, 28% had spinal cord injury (SCI), 34% multiple sclerosis (MS), and 38% had other causes. Twenty percent of the entire cohort initiated clean intermittent catheter (CIC), 20% already performed CIC, and 16% had indwelling catheters. No serious adverse events or hospital admissions were observed. CONCLUSIONS Intravesical BTA is a well-tolerated and safe procedure that is performed under local anesthetic in the majority of cases. Repeat treatments are common and popularity of BTA for patients with bladder dysfunction is growing. A significant number of patients initiated CIC in our blended cohort. Persistence with treatment is high, at 57%, despite the challenging nature of the patient population. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e942 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Richard Baverstock More articles by this author Bryce Weber More articles by this author Trafford Crump More articles by this author Daniel Yanko More articles by this author Kevin Carlson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,033 | 0,008 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».