Effect of Intravesical Onabotulinum Toxin (Type A) Injection in Neurogenic Overactive Bladder Due to Traumatic Spinal Cord Injury: A Single-arm Prospective Interventional Study

Background: Neurogenic overactive bladder in patients with suprasacral spinal cord injury (SCI) often responds poorly to the available conservative treatment. Although the cystoscopy-guided intravesical onabotulinum toxin Type A injection can help in this situation, data in the Indian population are still lacking. Aim and Objective: To observe the improvement following intravesical onabotulinum toxin (Type A) injection in neurogenic overactive bladder due to traumatic SCI. Materials and Methods: This single-arm prospective interventional study was conducted initially on 51 cases after taking institutional ethics committee clearance on patients of traumatic SCI with neurogenic overactive bladder assessed by urodynamic study (UDS). Cystoscopy-guided intravesical injection of onabotulinum toxin Type A: 200 units were given under strict aseptic conditions. Maximum cystometric capacity (MCC), first desire to void (FDV) and frequency of incontinence per week (Freq/W) were assessed as outcome parameters and noted at the baseline, 2 nd week, 6 th week and 12 th week post-procedure. Data of 47 patients were analysed as there were 4 dropouts. Results: Both the UDS parameters, i.e. MCC and FDV, along with the clinical parameter, i.e. Freq/W, showed post-procedure significant improvements ( P < 0.001), and those were sustained during subsequent follow-ups. Conclusion: For patients who are poorly responding to conservative management, intravesical onabotulinum toxin Type A injection can help them to improve their bladder function as a whole.