Botulinum Toxin Type A Injections for Treating Neurogenic Detrusor Overactivity Combined With Low-Compliance Bladder in Patients With Spinal Cord Lesions

Klaphajone, Jakkrit; Kitisomprayoonkul, Wasuwat; Sriplakit, Supon

doi:10.1016/j.apmr.2005.06.008

Cited by 61 publications

(26 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[2] P-value using paired Student's t-tests for dichotomous variables and analysis of variance for more than two variables to compare changes of Pdet.Qmax among patients with different variables. 16 or high values, as reported by Schurch et al 3 (32.6 ml per cm of H 2 O) and Reitz et al 4 (32 ml per cm of H 2 O).We also found no significant difference in therapeutic effects, either in UDI-6 or reduction of Pdet.Qmax, between patients with higher and lower baseline bladder compliances. The improvement in patients with low compliance, even with a long duration of illness, suggests that detrusor fibrosis is not solely responsible for severely decreased bladder compliance.…”

Section: Discussionsupporting

confidence: 83%

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Kuo

2011

Spinal Cord

View full text Add to dashboard Cite

Study design: The study was designed as a single-arm clinical trial. Objectives: To investigate the therapeutic effects of detrusor botulinum toxin A (BoNT-A) treatment in patients with different levels of spinal cord injury (SCI) and types of detrusor sphincter dyssynergia (DSD). Setting: Patients with chronic suprasacral SCI and neurogenic detrusor overactivity (NDO) were treated with 200-U BoNT-A detrusor injection in a tertiary university hospital in Taiwan. Methods: Outcome assessment of urodynamic parameters and therapeutic satisfaction were performed at 3 and 6 months among patients with different demographics, SCI levels and types of DSD. The treatment outcomes were assessed by changes in Urogenital Distress Inventory 6-item short form (UDI-6), quality of life (QoL) index and detrusor pressure at maximum flow rate (Pdet.Qmax). Results: A total of 38 patients with a mean age of 40.1±12.4 years and median duration of SCI of 10.3 years were enrolled. Satisfactory response was reported in 23 (60%) patients. Significant improvements in the UDI-6 and QoL were reported and significant increases of cystometric bladder capacity and post-void residual were noted in overall patients after treatment. Patients with different clinical demographics and urodynamic parameters had similar treatment outcomes and UDI-6 scores. In 11 patients receiving repeat injections of 300 U of BoNT-A after failure of a previous 200 U injection, the treatment outcomes were not significantly different, except that the PdetQmax at 6 months were higher in the group that received 200 U of BoNT-A. Conclusion: Patients with different SCI levels or DSD types had similar treatment outcomes after detrusor 200 U BoNT-A injections for NDO.

show abstract

Section: Discussionsupporting

confidence: 83%

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Kuo

2011

Spinal Cord

View full text Add to dashboard Cite

show abstract

“…*Mean MDP Klaphajone [45] 300 U 10 *Mean bladder *Increase in mean bladder compliance from 6.5 mL/cmH 2 O to compliance 13.2 mL/cmH 2 O, *Mean MCC *Complete continence in 7 patients, *Situation of *Increase in mean MCC (p=0.08), continence was observed.…”

Section: Surgical Techniquementioning

confidence: 97%

“…Furthermore, the increase in the maximum cystometric capacity and the decrease in the maximum detrusor pressure were also significant. Klaphajone et al [45] administered a 300 U BTX type A injection to 10 patients with spinal cord injuries and reported a low compliance. They reported that the mean bladder compliance increased from 6.5±5.0 mL/cmH 2 O to 13.2±5.2 mL/cmH 2 O following the injection.…”

Section: Deffontainesmentioning

confidence: 99%

Botulinum toxin injections for treating neurogenic detrusor overactivity

Bayrak

Sadioglu

Onur

2015

Turkish Journal of Urology

View full text Add to dashboard Cite

Neurogenic detrusor overactivity (NDO) is a disorder that can cause high intravesical pressure, decreased capacity, decreased bladder compliance, and upper urinary system damage. The current treatment options for NDO are established on the basis of agents that block parasympathetic innervation of the detrusor and inhibit involuntary bladder contractions. Several side effects, such as dryness of mouth, constipation, dyspepsia, changes in visual accommodation, somnolence, and being unable to obtain consistently favorable results, caused by anticholinergic agents, which are frequently used for this purpose, decrease the patient's compliance to treatment. Procedures such as neuromodulation, auto-augmentation, and enterocystoplasty are surgical options, and they could be used as the last alternative. Thus, botulinum toxin (BTX) injections to the detrusor have been commonly performed in recent years and lead to satisfactory results. The mechanism of action of BTX in NDO is based on the principal of smooth muscle relaxation in the bladder by the transient inhibition of neuromuscular nerve signals. The aim is to decrease acetylcholine secretion by blocking presynaptic vesicles in the neuromuscular junction. When studies were evaluated, it was observed that BTX injections to the detrusor muscle are a necessary and effective option in patients with incontinence caused by NDO. This treatment option could be indicated in situations where anticholinergic agents are not effective or could not be tolerated, and it could be a valuable alternative to major surgical treatments. In this review, we evaluated the effectiveness and reliability of BTX in patients with NDO.

show abstract

“…BoNT enjeksiyonlar› aras›ndaki zaman›n 7.6 ile 9.1 ay aras›nda de¤iflti¤ini belirtmifllerdir. Ancak özellikle düflük kompliansl› mesanesi olan hastalarda tekrar enjeksiyon süresinin 2-3 aya kadar düflebilece¤i belirtilmifltir (22) .…”

Section: Botul‹nyum Toks‹n‹ Enjeks‹yonuunclassified

Botulinum toxin and neuromodulation for overactive bladder treatment

Akman¹

2013

J Turk Soc Obstet Gynecol

View full text Add to dashboard Cite

show abstract

Botulinum Toxin Type A Injections for Treating Neurogenic Detrusor Overactivity Combined With Low-Compliance Bladder in Patients With Spinal Cord Lesions

Cited by 61 publications

References 13 publications

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia

Botulinum toxin injections for treating neurogenic detrusor overactivity

Botulinum toxin and neuromodulation for overactive bladder treatment

Contact Info

Product

Resources

About