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KMID : 1161920160130020111
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Journal of Medicine and Life Science
2016 Volume.13 No. 2 p.111 ~ p.116
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Clinical approach of botulinum toxin A (Botoxⓡ) of treatment for patients with overactive bladder
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Kim Kyung-Hoe
Huh Jung-Sik
Kim Young-Joo
Park Kyung-Kgi
Kim Sung-Dae
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Abstract
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Candidates for botulinum toxin A are generally patients with overactive bladder(OAB) whose disease is in adequately controlled with behavioral therapy and oral medication. All patients must be willing and able to perform clean intermittent catheterization(CIC). Before the decision to administer botulinum toxin A is made, the clinician should provide counseling to the patient regarding the agent’s indications, proposed benefis, risks, and mode of administration. The patient should be aware that botulinum toxin A takes effect after approximately 1?2weeks and usually lasts for 4?10months, after which repeat injections will be necessary to maintain effect. Patient preparation may include pre-treatment antibiotics and withdrawal of antiplatelet therapy or anticoagulants. Preparation of the product involves reconstitution in sterile saline and dilution according to the planned dose. The injections are performed using a flxible or rigid cystoscope, and the procedure takes approximately 15 min. The initial follow-up visit occurs within 7?14 days, when evidence of adverse effects, including urinary retention, can be evaluated. Repeat injections can be scheduled as needed, but not sooner than 3 months. Currently, the total dose of botulinum toxin A should not exceed 360 U in a 3-month period for all indications, including those outside the urinary tract (i.e.,cosmetic, ophthalmologic,etc.). Overall, botulinum toxin A is effective, generally well tolerated, safe, and is relatively simple to provide.
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KEYWORD
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Bladder, Overactive, Botulinum toxin, Treatment
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