Botulinumtoxin bei Blasenfunktionsstörungen

Zusammenfassung

Die neurogene Detrusorhyperaktivität und die nicht-neurogene. sog. idiopathische überaktive Blase (engl. Overactive Bladder OAB) sind gekennzeichnet durch einen imperativen Harndrang mit oder ohne Harninkontinenz, eine deutlich erhöhte Miktionsfrequenz, und sie sind häufig begleitet von einer Nykturie. Als second-line Therapie nach Versagen einer anticholinergen Behandlung dieser Erkrankungen hat sich die OnabotulinumtoxinA Detrusorinjektion fest etabliert. Der Eingriff ist sowohl im stationären als auch im ambulanten Setting und unter Allgemein- oder Lokalanästhesie durchführbar. Nebenwirkungen betreffen hauptsächlich das Auftreten von Harnwegsinfekten sowie – insbesondere bei neurogen bedingten Funktionsstörungen – den Harnverhalt. Wenn der Neurologe Hinweise auf eine Detrusorhyperaktivität hat und bisherige medikamentöse Therapieversuche nicht zu dem gewünschten Erfolg führen, empfiehlt sich somit eine Vorstellung beim Urologen zur Frage der OnabotulinumtoxinA-Detrusorinjektion.

Dieser Artikel beschränkt sich auf die zugelassenen Indikationen der OnabotulinumtoxinA Detrusorinjektionen und fasst ihre aktuelle Datenlage zusammen.

Abstract

An overactive neurogenic detrusor and an non-neurogenic overactive bladder both exhibit symptoms such as urgency and frequency, both with and without urinary incontinence, and are often accompanied by nocturia. OnabotulinumtoxinA-Detrusorinjection has become well established as a second line therapy in cases where anticholinergic medication has failed. The procedure can be performed under general or local anesthesia, in both in- and outpatient settings. The side effects of the procedure are primarily urinary tract infections and – especially in neurogenic bladder patients – urinary retention. This article focuses on the approved indications and summarizes the current scientific data.

Schlüsselwörter

neurogene Blase - Botulinumtoxin - Inkontinenz - OAB

Key words

neurogenic bladder - incontinence - OAB - botulinum toxin

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