| 과민성방광 환자에서 botulinum toxin A (Botoxⓡ)
치료에 대한 임상적 접근 |
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| Clinical approach of botulinum toxin A (Botoxⓡ) of treatment for patients
with overactive bladder |
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Kyung Hoe Kim, Jung-Sik Huh, Young Joo Kim, Kyung kgi Park, Sung Dae Kim |
Correspondence:
Sung Dae Kim,
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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. |
| Key Words:
Bladder, Overactive, Botulinum toxin, Treatment |
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