Should we conduct biofeedback treatment after botulinum toxin injections into pelvic floor muscles in women with dysfunctional voiding in cases when the first line biofeedback was not effective.

Romikh V1, Borisenko L1, Zakharchenko A1, Panteleev V1, Romikh P1

Research Type

Clinical

Abstract Category

Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Abstract 351
Open Discussion ePosters
Scientific Open Discussion Session 21
Thursday 30th August 2018
13:25 - 13:30 (ePoster Station 4)
Exhibition Hall
Voiding Dysfunction Bladder Outlet Obstruction Pelvic Floor
1. Research institute of urology
Presenter
V

Victoria Romikh

Links

Abstract

Hypothesis / aims of study
Introduction. Lack of pelvic floor muscles (PFM) relaxation in women is the reason for dysfunctional voiding (DM) symptoms: difficult “start”, interrupted or weak stream, incomplete empting. Biofeedback (BFB) in the relaxation mode is often used as the first line treatment demonstrating good results. In cases when BFB has no or low effect botulinum toxin type A (BTA) injections into PFM can be used as the next line treatment. 
Aim of study. To evaluate the clinical efficiency of BFB after BTA therapy in women with  DV which had no effect at the first line BFB treatment.
Study design, materials and methods
The results of treatment of 140 women age 22 – 65 were analyzed.  The diagnoses of DM was confirmed by urodynamics. BFB in the relaxation mode was conducted as the first line therapy. The treatment was effective in 102 women (64%), and not effective in 58 (36%). At the second line patients with no effect of BFB (N=58) were injected with BTA into PFM (100 Uts). 6-12 months later when BTA effect decreased and “obstructive” symptoms came back another BFB series was conducted.
Results
Two groups were formed after the BTA treatment: I - 49 patients (84%) with BTA effectiveness, II – 9 (16%) with no or low effect. Another BFB series was effective in 25 of 49 women (57%) in group I, and in 3 of 9 women (33%) in group II.
Interpretation of results
The summarized effectiveness was 48,3%
Concluding message
BFB is an effective first line therapy for DV women.  BTA injections into PFM is an effective when BFB has low or no effect. Another BFB series after BTA treatment for DV women with no effect at the first line BFB proved to be effective in almost a half of patients.  It should be taken into consideration when planning the treatment strategy.
Disclosures
Funding No Clinical Trial No Subjects Human Ethics Committee Ethics committee Research institute of urology Helsinki Yes Informed Consent Yes
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