Five-year follow-up of patients treated with intra-dermal botulinum toxin for axillary hyperhidrosis.

BACKGROUND: Axillary hyperhidrosis is a common complaint affecting 5% of the general population. It can significantly impact quality of life (QOL) and may be extremely debilitating. Administration of intra-dermal botulinum toxin type-A (Botox) has been proven to be effective in managing axillary hyperhidrosis; however, to date, no long-term data has assessed its efficacy. AIM: We aim to assess long-term (> 5 years) QOL outcomes in this patient cohort. METHODS: In this single-centre series, all patients attending for axillary botox, with five or more years of follow-up, were prospectively included. QOL was assessed in all patients using the validated assessment tool, the modified Dermatology Life Quality Index (DLQI). Standard statistical methods were utilised with data reported as mean (± standard deviation). Subgroup analysis utilising previously published departmental data allowed for further assessment of change in QOL over time. RESULTS: A total of 75 patients (83% female) met the inclusion criteria with 67% completing the DLQI assessment. Follow-up ranged from 5 to 10 years with a mean age of 37.6 years (± 8.82). The mean number of treatments over the study period was 12 (± 3.1). Mean overall post-treatment DLQI score was 1.6 (± 2.01). This represented a significant improvement in patient QOL (p = < 0.0001) associated with long-term botox application. This statistical significance was identified consistently across all components of the DLQI tool. CONCLUSION: These data suggest that the established early QOL benefits associated with intra-dermal botox administration for AH are sustained in the long term. This benefit was seen across all subsets of the DLQI tool.

The utility of stent on strings in clinical practice.

INTRODUCTION: Various types of ureteric stents are used in the management of ureteric stones. Stents on strings (SOS) are an attractive option as they may be removed without the need for instrumentation. There is some hesitation using SOS due to perceived complications and the risk of premature dislodgement. The aim of this study was to evaluate the utility of SOS compared with the conventional stent (CS). METHODS: A retrospective review was performed on all ureteric stents removed in the urology department over a 7-month period. Only stents inserted during the endoscopic management of ureteric stones were included in analysis. Patients were contacted to identify the incidence of those seeking medical attention while the stent was in situ or within 2 weeks of stent removal. A basic cost analysis was performed. RESULTS: One hundred and sixty cases were identified (98 CS, 62 SOS). No SOS was dislodged prematurely. One SOS was removed cystoscopically due to a broken string. There was no significant difference in the number of patients with SOS seeking medical attention following stent placement compared with those with CS (38.1% (12/51) vs 25.6% (22/86), p = 0.48). There was an estimated cost saving of €23,790 associated with the use of SOS during the study period (€390/case). The use of SOS created additional capacity which was utilised for diagnostic cystoscopy. CONCLUSION: The SOS appeared to be well tolerated and showed similar complication rates as the CS. The use of SOS resulted in a significant cost saving and increased the availability of cystoscopy for other indications.