Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
The Effect of Intravesical OnabotulinumtoxinA Injection on Women Sexual Function in Overactive Bladder Treatment: Observational Study
Aşırı Aktif Mesane Tedavisinde Kullanılan İntravezikal OnabotulinumtoksinA Enjeksiyonunun Kadın Cinsel Fonksiyonu Üzerindeki Etkisi: Gözlemsel Çalışma
Erkan MERDERa, Mehmet Gökhan ÇULHAa, Ahmet ARIMANa, Bahadır ERMEÇa, Murat ÖZERa, Fatih ALTUNRENDEa
aDepartment of Urology, University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, TURKEY
J Reconstr Urol. 2021;11(2):79-83
doi: 10.5336/urology.2021-82624
Article Language: EN
Full Text
ABSTRACT
 Objective: To investigate the effect of intravesical onabotulinumtoxinA (Botox) injection on female sexual function in women with overactive bladder (OAB) and to evaluate its relationship with OAB symptoms. Material and Methods: Data from 56 patients with idiopathic OAB and who were resistant to medical therapy between January 2018 and July 2019 were evaluated. The patients were evaluated with an overactive bladder symptom score (OABSS) and female sexual function index (FSFI) before and after 100 IU Botox treatment. The changes in the symptom scores of the patients and the FSFI scores were compared. Results: A total of 38 patients completed the study. The mean age of the patients was 41.59±11.79 (31-56), and the mean body mass index was 30.02±4.77 kg/m2. Mean duration of complaints was 48,93±45,32 months and mean number of pads daily used was 3,92±2,39. For the treatment of idiopathic OAB, 100IU Botox application to each patient was performed in 20 regions. Significant improvement was observed in the OABSS scores of the patients 12 weeks after treatment (10.32±3.01 to 4.68±2.21; p<0.001). When the FSFI scores were examined, a significant improvement was observed in the FSFI-desire, arousal, satisfaction, and pain subgroups and total FSFI score 12 weeks after the procedure. In the post-treatment evaluation, 94.73% of the patients were satisfied with the treatment. Urinary retention occurred in two patients. Conclusion: As a result of our study, intravesical botox injections have been shown to improve sexual function in women with OAB. More extensive studies are needed to better evaluate the effects of botox injection on sexual functions.

Keywords: Overactive bladder; botox; female sexual function; urge urinary incontinence
ÖZET
 Amaç: Aşırı aktif mesane (AAM) semptomları kadın cinsel fonksiyonu üzerinde olumsuz bir etkiye sahiptir. Bu çalışmanın amacı, AAM'li kadınlarda intravezikal onabotulinumtoksinA (Botoks) enjeksiyonunun kadın cinsel fonksiyonu üzerindeki etkisini araştırmak ve AAM semptomları ile ilişkisini değerlendirmektir. Gereç ve Yöntemler: Ocak 2018-Temmuz 2019 tarihleri arasında idiopatik AAM tanısı olan ve medikal tedaviye dirençli 56 hastanın verileri değerlendirildi. Hastalar 100 IU Botoks tedavisi öncesi ve tedaviden 12 hafta sonra aşırı aktif mesane semptom skoru (OABSS) ve kadın cinsel fonksiyon indeksi [female sexual function index (FSFI)] ile değerlendirildi. Hastaların semptom skorlarındaki değişiklikler ile FSFI skorları arasındaki değişiklikler karşılaştırıldı. Bulgular: Çalışmayı 38 hasta tamamladı. Hastaların yaş ortalaması 41,59±11,79 (31-56), beden kitle indeksi ortalaması 30,02±4,77 idi. Hastaların şikâyet süreleri ortalaması 48,93±45,32 ay, günlük ped kullanımı ortalaması 3,92±2,39'du. İdiopatik AAM tedavisi için her hastaya 100IU Botoks uygulaması 20 bölgeye yapıldı. Tedaviden 12 hafta sonra hastaların OABSS skorlarında anlamlı iyileşme izlendi (10,32±3,01'e 4,68±2,21; p<0,001). FSFI skorları incelendiğinde işlemden 12 hafta sonra FSFI-istek, uyarılma, doyum ve ağrı alt grupları ile toplam FSFI skorunda anlamlı iyileşme olduğu izlendi. Tedavi sonrası değerlendirmede hastaların %94,73'ü tedaviden memnundu. İki hastada idrar retansiyonu gerçekleşti. Sonuç: Çalışmamız sonucunda, intravezikal botoks enjeksiyonlarının AAM'li kadınlarda cinsel fonksiyonu iyileştirebileceği gösterilmiştir. Botoks enjeksiyonunun cinsel fonksiyonlar üzerine etkilerinin daha iyi değerlendirilmesi için konu ile ilgili daha geniş çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Aşırı aktif mesane; botoks; kadın cinsel fonksiyonu; sıkışma tipi idrar kaçırma
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