Neuro-urology Botulinum Toxin A Improves the Quality of Life of Patients with Neurogenic Urinary Incontinence Brigitte Schurch a, *, Pierre Denys b , Chris M. Kozma c , Pat Ray Reese d , Terra Slaton c , Richard L. Barron e a Spinal Cord Injury Center, University Hospital Balgrist, Zurich, Switzerland b Ho ˆ pital Raymond Poincare ´, Garches, Paris, France c University of South Carolina, Columbia, SC, USA d Reese Associates Consulting, LLC, Cary, NC, USA e Allergan Inc., Irvine, CA, USA european urology 52 (2007) 850–859 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted April 3, 2007 Published online ahead of print on April 19, 2007 Keywords: Botulinum toxin type A I-QOL Neurogenic urinary incontinence Quality of life Validity Abstract Objective: To evaluate the impact of botulinum toxin type A (BoNTA) on health-related quality of life in patients with neurogenic urinary incon- tinence (UI) using the Incontinence Quality of Life questionnaire (I-QOL). Methods: Randomized, double-blind, multicenter, placebo-controlled study involving eight centers across Belgium, France, and Switzerland. Patients (n = 59) with UI due to neurogenic detrusor overactivity (spinal cord injury, n = 53; multiple sclerosis, n = 6) who were inadequately managed on oral anticholinergics received a single dose of BoNTA (200 U or 300 U, Botox 1 ) or placebo. I-QOL scores at screening and after treatment at weeks 2, 6, 12, 18, and 24 were recorded. Results: Median total and subscale I-QOL scores increased significantly from screening with BoNTA 300 U compared with placebo at all time points ( p < 0.05) and with BoNTA 200 U compared with placebo at all time points for total score and the Avoidance Limiting Behavior subscale ( p < 0.05), and at weeks 2, 6, 12, and 18 ( p < 0.05), but not 24 for the Psychosocial Impact and Social Embarrassment subscales. Approxi- mately twice as many BoNTA recipients as placebo recipients achieved at least a minimal important difference in total I-QOL score at 2, 6, 12, and 24 wk. Conclusions: BoNTA significantly improves UI-associated health-related quality of life in patients with neurogenic UI. # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland. Tel. +41 443863845; Fax: +41 443863909. E-mail address: schurchb@paralab.balgrist.ch (B. Schurch). 0302-2838/$ – see back matter # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2007.04.026