Guoqing Chen1, Limin Liao. 1. Department of Urology, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University, 100068 Beijing, China.
Abstract
BACKGROUND: To present a comprehensive experience of botulinum toxin A (BTX-A) injected into the detrusor muscle in patients with spinal cord injuries (SCI) causing neurogenic detrusor overactivity. METHODS: Three hundred units of BTX-A were injected cystoscopically into the detrusor muscle of 108 patients with neurogenic detrusor overactivity secondary to SCI at 30 different locations. Evaluations were performed before the injections and 6 weeks after, and they included determination of bladder urinary continence status, frequency/volume chart of CIC, concomitant anticholinergic medication use, Incontinence Quality of Life questionnaire (I-QOL) and patient satisfaction. Key urodynamic parameters (reflex volume, maximum detrusor pressure during voiding, detrusor compliance and maximum cystometric capacity) were analyzed at the outset and during the follow-up (6, 12 and 36 weeks) examinations. RESULTS: By the time of the urodynamic follow-up examinations (6, 12 and 36 weeks), the mean cystometric capacity (P < 0.05) and the mean reflex volume (P < 0.05) increased significantly, while the mean voiding pressure (P < 0.05) decreased significantly. No complications or side effects were reported. Most patients considerably reduced or even stopped taking anticholinergic drugs and were satisfied with the treatment. CONCLUSIONS: This retrospective study indicates that BTX-A injections into the detrusor muscle to treat neurogenic detrusor overactivity secondary to SCI are safe and valuable. Significant improvement of bladder function corresponded with continence and subjective satisfaction indicated by the treated patients.
BACKGROUND: To present a comprehensive experience of botulinum toxin A (BTX-A) injected into the detrusor muscle in patients with spinal cord injuries (SCI) causing neurogenic detrusor overactivity. METHODS: Three hundred units of BTX-A were injected cystoscopically into the detrusor muscle of 108 patients with neurogenic detrusor overactivity secondary to SCI at 30 different locations. Evaluations were performed before the injections and 6 weeks after, and they included determination of bladder urinary continence status, frequency/volume chart of CIC, concomitant anticholinergic medication use, Incontinence Quality of Life questionnaire (I-QOL) and patient satisfaction. Key urodynamic parameters (reflex volume, maximum detrusor pressure during voiding, detrusor compliance and maximum cystometric capacity) were analyzed at the outset and during the follow-up (6, 12 and 36 weeks) examinations. RESULTS: By the time of the urodynamic follow-up examinations (6, 12 and 36 weeks), the mean cystometric capacity (P < 0.05) and the mean reflex volume (P < 0.05) increased significantly, while the mean voiding pressure (P < 0.05) decreased significantly. No complications or side effects were reported. Most patients considerably reduced or even stopped taking anticholinergic drugs and were satisfied with the treatment. CONCLUSIONS: This retrospective study indicates that BTX-A injections into the detrusor muscle to treat neurogenic detrusor overactivity secondary to SCI are safe and valuable. Significant improvement of bladder function corresponded with continence and subjective satisfaction indicated by the treated patients.
Authors: Carlos R M Rieder; Pedro Schestatsky; Mariana Peixoto Socal; Thaís Lampert Monte; Daniele Fricke; João Costa; Paulo Dornelles Picon Journal: Clin Neuropharmacol Date: 2007 Jan-Feb Impact factor: 1.592
Authors: Heinrich Schulte-Baukloh; Catarina Weiss; Thomas Stolze; Jaqueline Herholz; Burkard Stürzebecher; Kurt Miller; Helmut H Knispel Journal: Eur Urol Date: 2005-07-18 Impact factor: 20.096
Authors: Satoshi Hori; Prasad Patki; Kaka H Attar; Soran Ismail; Joana C Vasconcelos; P Julian R Shah Journal: BJU Int Date: 2009-02-10 Impact factor: 5.588
Authors: Michael Akbar; Rainer Abel; Thorsten M Seyler; Jens Bedke; Axel Haferkamp; Hans J Gerner; Klaus Möhring Journal: BJU Int Date: 2007-05-26 Impact factor: 5.588
Authors: André Reitz; Manfred Stöhrer; Guus Kramer; Giulio Del Popolo; Emmanuel Chartier-Kastler; Jürgen Pannek; Harald Burgdörfer; Konrad Göcking; Helmut Madersbacher; Stefan Schumacher; Rudolf Richter; Jan von Tobel; Brigitte Schurch Journal: Eur Urol Date: 2004-04 Impact factor: 20.096
Authors: Emma Svensson; Peter Zvara; Niels Qvist; Lars Hagander; Sören Möller; Lars Rasmussen; Henrik Daa Schrøder; Eva Kildall Hejbøl; Niels Bjørn; Súsanna Petersen; Kristine Cederstrøm Larsen; Jan Krhut; Oliver J Muensterer; Mark Bremholm Ellebæk Journal: Int J Surg Protoc Date: 2021-08-11