Treating Neurogenic Lower Urinary Tract Dysfunction in Chronic Spinal Cord Injury Patients—When Intravesical Botox Injection or Urethral Botox Injection Are Indicated

Abstract

Lower urinary tract symptoms (LUTS), such as urgency, urinary incontinence, and/or difficulty voiding, hamper the quality of life (QoL) of patients with spinal cord injury (SCI). If not managed adequately, urological complications, such as urinary tract infection or renal function deterioration, may further deteriorate the patient’s QoL. Botulinum toxin A (BoNT-A) injection within the detrusor muscle or urethral sphincter yields satisfactory therapeutic effects for treating urinary incontinence or facilitating efficient voiding; however, adverse effects inevitably follow its therapeutic efficacy. It is important to weigh the merits and demerits of BoNT-A injection for LUTS and provide an optimal management strategy for SCI patients. This paper summarizes different aspects of the application of BoNT-A injection for lower urinary tract dysfunctions in SCI patients and provides an overview of the benefits and drawbacks of this treatment.

Rehabilitation of spinal patients with diseases and injury of the cervical spine in the early and late postoperative period (analysis of russian and foreign recommendations)

“…При сохраняющейся мочевыводящей и аноректальной дисфункции решение о форме оказания медицинской помощи определяется пациентом в виде информированного согласия на основании рекомендаций членов междисциплинарной бригады (невролога, уролога, проктолога, физиотерапевта и нейрохирурга) [53,54]. К таковым относятся внутрисфинктерные инъекции ботулотоксина А [55], лапароскопическая имплантация нейромодулирующих электродов [56], тибиальная, постоянная сакральная стимуляция, ритмическая транскраниальная магнитная стимуляция [32,52].…”

Local Drug Delivery in Bladder Cancer: Advances of Nano/Micro/Macro-Scale Drug Delivery Systems

“…To overcome this matter, different approaches including mucoadhesive drug delivery systems and pre-treatment with special agents can be implemented [ 9 , 14 , 15 ]. Potentially, drugs may be injected into the bladder wall by analogy with the intradetrusorial injection of a botulinum toxin, and this is generally accepted in the case of the lower urinary tract dysfunctions [ 16 ].…”