Use of Myomo for Individuals with Amyotrophic Lateral Sclerosis ALS: A Case Series

Abstract

Research Objectives: To describe the symptomatic urinary tract infection rates (UTI) in three groups of patients with spinal cord injury and neurogenic bladder (NB) after detrusor botulinum toxin A (BoNTA) injection, treated in the pre-operative for asymptomatic bacteriuria (AB) with different antibiotic duration regimens (more than 3 days, 3 days, single dose). Design: Retrospective review. Setting: Rehabilitation Hospital. Participants: Convenience sample of 487 adult patients, with traumatic and non-traumatic spinal cord injury, performing self or assisted clean intermittent bladder catheterization, who underwent detrusor BoNTA injection, between January 2007 and December 2013. Interventions: Not Applicable. Main Outcome Measure(s): Occurrence of UTI during the first week after the detrusor BoNTA injection in three groups of patients according to the duration of antibiotics for the treatment of AB. Results: A total of 616 procedures were performed during the study period. Among the patients evaluated 68% were male; the mean age was 37 years (AE 11.6); 66% of patients had traumatic spinal cord injury and 34% non-traumatic spinal cord injury. There were 11 cases of UTI (1.8%), 5 patients within the group that had antibiotic for more than 3 days (4.8%), 1 case within the group that had antibiotic for 3 days (0.6%) and 5 patients within the group that had a single dose (1.5%). Conclusions: It was observed that symptomatic UTI rates related to detrusor BoNTA injection in patients with NB is low regardless of the duration of antibiotics for the treatment of AB. Randomized clinical trials should be conducted to conclusions about the treatment of AB in patients candidates for BoNTA.