Our results show that intradetrusor botulinum-A toxin injections may be an efficient and safe treatment option in patients with severe overactive bladder resistant to all conventional treatments.

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In our study injection of botulinum toxin into the detrusor muscle did not lead to increased fibrotic activity within the bladder wall, on the contrary patients with previous botulinum toxin injection revealed significant less fibrosis than patients without toxin injection.

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To provide a comprehensive insight into sexuality after spinal cord injury, 120 patients received a questionnaire to assess their sexual activities, abilities, desires, satisfaction and sexual adjustment after injury. In the 63 responding patients, spinal cord injury had a major impact on sexual function. Relationship to partner, social life, bladder management and physical well-being had a significant impact on quality of life. Relationship to partner, ability to move and mental well-being, as well as aspects of sexual desire and body image had a significant correlation to satisfaction with sexual life. In the studied population, there was no significant correlation between preserved sexual abilities after spinal cord injury and the satisfaction with sexual life.

Simultaneous dorsal clitoral nerve stimulation during bladder filling reduced the activation of certain cortical areas suggesting a neuromodulatory effect of this stimulation on supraspinal centres involved in lower urinary tract control.

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