Volume 53, Issue 6, Pages 1245-1253 (June 2008) Histological Changes in the Urothelium and Suburothelium of Human Overactive Bladder following Intradetrusor Injections of Botulinum Neurotoxin Type A for the Treatment of Neurogenic or Idiopathic Detrusor Overactivity  Apostolos Apostolidis, Thomas S. Jacques, Alex Freeman, Vinay Kalsi, Roshni Popat, Gwendoline Gonzales, Soumendra N. Datta, Shabnam Ghazi-Noori, Sohier Elneil, Prokar Dasgupta, Clare J. Fowler  European Urology  Volume 53, Issue 6, Pages 1245-1253 (June 2008) DOI: 10.1016/j.eururo.2008.02.037 Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 1 Percentage of inflammation-positive biopsies before treatment and after one or repeat injections in the whole study population. A trend for increased evidence of inflammatory signs was noted in biopsies taken after the first and repeat injections compared with those obtained before treatment. European Urology 2008 53, 1245-1253DOI: (10.1016/j.eururo.2008.02.037) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 2 No significant change was seen in degree of inflammation in biopsies taken from the whole study population after the first and repeat injections compared with those obtained before treatment. European Urology 2008 53, 1245-1253DOI: (10.1016/j.eururo.2008.02.037) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 3 Percentage of eosinophil-positive biopsies before treatment and after one or repeat injections in the whole study population. There was increased evidence of eosinophils in biopsies taken after the first and repeat injections compared with those obtained before treatment. European Urology 2008 53, 1245-1253DOI: (10.1016/j.eururo.2008.02.037) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 4 Mean inflammatory score did not change in biopsies obtained after the first injection in either the NDO or IDO subgroup of patients, although a progressive increase was noted in absolute values in the NDO population. European Urology 2008 53, 1245-1253DOI: (10.1016/j.eururo.2008.02.037) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 5 Top panel: representative photographs from (a) NDO specimen and (b) IDO specimen at baseline. No significant difference existed between NDO and IDO bladders in degree of baseline inflammation. Photographs in the bottom panel show the presence of inflammatory findings in NDO specimens after BoNTA treatment. Arrows indicate increased numbers of lymphocytes at 4 wk post-BoNTA (c), and a larger number of lymphocytes forming a well-circumscribed node at 16 wk post-BoNTA (d). Despite the increase in mean values, the inflammatory score remained unchanged compared with baseline. All photos were taken at ×40 magnification. European Urology 2008 53, 1245-1253DOI: (10.1016/j.eururo.2008.02.037) Copyright © 2008 European Association of Urology Terms and Conditions