The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Braz J Infect Dis 2018;22:79-84 - Vol. 22 Num.2 DOI: 10.1016/j.bjid.2017.10.009
Original article
Onabotulinumtoxin type A improves lower urinary tract symptoms and quality of life in patients with human T cell lymphotropic virus type 1 associated overactive bladder
Jose Abraão Carneiro Netoa,b, Silvane Braga Santosb,c, Gloria Orge Orgeb, Davi Tanajuraa, Lucia Passosb, Cassius José Oliveiraa, Rosana Andradea, Cláudio Galeno de Melod, Ubirajara Barrosod, Edgar M. Carvalhod,e,f,,
a Universidade Federal da Bahia (UFBA), Programa de Pós-Graduação em Ciências da Saúde, Salvador, BA, Brazil
b Universidade Federal da Bahia (UFBA), Hospital Universitário Prof. Edgard Santos, Serviço de Imunologia, Salvador, BA, Brazil
c Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil
d Universidade Federal da Bahia (UFBA), Hospital Universitário Prof. Edgard Santos, Serviço de Urologia, Salvador, BA, Brazil
e Fiocruz Bahia, Instituto Gonçalo Moniz, Laboratório de Pesquisa Clínica, Salvador, BA, Brazil
f Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais (INCT-DT), Salvador, BA, Brazil
Received 02 August 2017, Accepted 30 October 2017
Abstract
Aim

To evaluate the efficacy of the onabotulinum toxin type A in the treatment of HTLV-1 associated overactive bladder and its impact on quality of life (QoL).

Methods

Case series with 10 patients with overactive bladder refractory to conservative treatment with anticholinergic or physical therapy. They received 200Ui of onabotulinumtoxin type A intravesically and were evaluated by overactive bladder symptoms score (OABSS) and King's Health Questionnaire.

Results

The mean (SD) of the age was 52+14.5 years and 60% were female. All of them had confirmed detrusor overactivity on urodynamic study. Seven patients had HAM/TSP. The median and range of the OABSS was 13 (12–15) before therapy and decreased to 1.0 (0–12) on day 30 and to 03 (0–14) on day 90 (p<0.0001). There was a significant improvement in 8 of the 9 domains of the King's Health Questionnaire after the intervention. Hematuria, urinary retention and urinary infection were the complications observed in 3 out of 10 patients. The mean time to request retreatment was 465 days.

Conclusion

Onabotulinum toxin type A intravesically reduced the OABSS with last long effect and improved the quality of life of HTLV-1 infected patients with severe overactive bladder.

Keywords
Overactive bladder, Onabotulinum toxin, HTLV-1
Braz J Infect Dis 2018;22:79-84 - Vol. 22 Num.2 DOI: 10.1016/j.bjid.2017.10.009