Botulinum-A toxin injection into detrusor to treat detrusor hyperreflexia and neurogenic incontinence in patients with spinal cord injury
- VernacularTitle:经尿道膀胱壁A型肉毒毒素注射治疗脊髓损伤患者逼尿肌反射亢进及神经原性尿失禁
- Author:
Limin LIAO
;
Dong LI
;
Zongsheng XIONG
- Publication Type:Journal Article
- Keywords:
Botulinum-A toxin;
Detrusor injection;
Detrusor hyperreflexia;
Incontinence;
Spinal cord injury
- From:
Chinese Journal of Urology
2001;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of Botulinum-A toxin (BTX-A) injection into detrusor to treat detrusor hyperreflexia and neurogenic incontinence in the patients with spinal cord injury (SCI). Methods A total of 31 patients with SCI(mean age,30 years;male 20,female 11) were included into the study.All the patients underwent urodynamic examination and voiding diary was recorded.300 U of BTX-A was dissolved in 15 ml of saline,and the solution of BTX-A was injected into 30 different points in detrusor using a flexible cystoscopic needle.The evaluation for the effects and follow-up included voiding diary,urodynamic testing and observation of adverse and toxic effects. Results After the first injection,29 of the 31 patients had symptom relief within 3 to 14 days;4 cases received the second injection;4 cases were treated in combination with anticholinergic medication;and 2 cases had no improvement and,therefore,received other treatments.The mean follow-up was 8.5 months. After 3-week treatment of BTX-A,the mean frequency of incontinence decreased from 14.2 to 2.5 times per day.The mean volume of intermittent catheterization (IC) increased from 124 to 495 ml each time.Urodynamic data showed that mean cystometric bladder storage volume increased from 133 to 475 ml,mean maximum storage detrusor pressure decreased from 62.7 to 17.1 cmH 2O(1 cmH 2O=0.098 kPa).No adverse and toxic effect was observed. Conclusions Our initial experience suggests that Botulinum-A toxin injection into detrusor to treat detrusor hyperreflexia and neurogenic incontinence in patients with SCI may be an effective,safe,feasible and micro-invasive treatment choice.However,it is necessary to observe its long term outcome.
