Botulinum-a Toxin for Treating Detrusor Hyperreflexia in Spinal Cord Injured Patients: A New Alternative to Anticholinergic Drugs? Preliminary Results

Schurch, Brigitte; Stöhrer, M.; Kramer, Guus; Schmid, Daniel; Gaul, G.; Hauri, D.

doi:10.1016/s0022-5347(05)67283-7

Cited by 668 publications

(134 citation statements)

References 30 publications

Supporting

Mentioning

111

Contrasting

Unclassified

Order By: Relevance

“…This amount was accepted in numerous subsequent studies and has been successful [15,19,20]. Some authors reported they administered 300 units of BTX-A in NDO and NNDO conditions while the others stated they used 200 units in NNDO and 300 in NDO [7,18,21]. We administered BTX-A injection as 300 units in 4 neurogenic patients and 200 units in 14 NNDO patients.…”

Section: Discussionmentioning

confidence: 96%

“…Reason of the trigone not to be injected BTX-A was stated as the paralysis occurring in the trigone might cause to vesicoureteral reflux (VUR) [7]. However, Smith et al stated that they performed the injection of BTX particularly into the trigone site in NDO [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Schurch et al are the first applying this procedure on the widest series and they applied BTX-A injection with 300 units [7]. This amount was accepted in numerous subsequent studies and has been successful [15,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…The injection was made into posterior and lateral walls and to the trigone region. Four patients with NDO were administered 300 units to 30 different points, while 1 MS patient and remaining 14 patients with NNDO received 200 units to 20 different points as described previously [7]. Follow-up of the patients was carried out through ICIQ-SF and satisfaction forms (Questionnaire-1) used in our clinics at postoperative 3rd weeks and 6th months.…”

Section: Methodsmentioning

confidence: 99%

“…In urological area, BTX has been used in detrusor sphincter dyssynergia (DSD) [5], urinary dysfunction [6], neurogenic detrusor overactivity (NDO) [7] or idiopathic/ non-neurogenic detrusor overactivity (NNDO) [8], chronic prostatitis [9], chronic pelvic pain syndrome [10] and…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Botulinum Toxin-A for the Treatment of Voiding Dysfunction: Our Initial Experience

Çitgez¹,

Önal²,

Gevher³

et al. 2012

OJU

View full text Add to dashboard Cite

Objective: Evaluation of Botulinum Toxin-A (BTX-A) as an alternative treatment option in patients whom previous treatments were failed. Methods: Between March 2005 and September 2006, a total 19 patients; 16 patients with overactive bladder (5 neurologic, 11 idiopathic), 2 with nocturnal enuresis, 1 with interstitial cystitis, intravesical BTX-A injection was applied. Except one patient, 18 patients with a median age 46 (20 -80) were registered to the study. Patients were examined at postoperative 3 weeks and 6 months with ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and satisfaction forms used in our clinic. Results: The median follow-up time was 16 months (6 -18). When evaluated according to diagnosis, symptoms were improved 100% in neurologic overactive bladder (5/5), 80% in idiopathic overactivity (8/10), 50% in nocturnal enuresis (1/2). In one patient with interstitial cystitis there was no improvement. Median efficiency time of BTX-A treatment was 6 months (1 -17). At 3 weeks and 6 months after the treatment, ICIQ-SF score was decreased to 3.6 and 7.5 respectively from preoperative level of 18.7. Quality of life scores at preoperative, 3 week and 6 months were 9.7, 2.7 and 4.3 respectively. Except 3 patients with overactive neurologic bladder because of spinal cord injury, symptoms of patients with pollacuria and nocturia decreased at 3. week. Even if these rates increased at 6 months they still were significantly less than preoperative status. The spinal cord injured 3 patients had clean intermittent catheterization per 1 hour and had urinary incontinence between the catheterizations preoperatively, however at 3 weeks and 6 months the intervals of catheterisations was 4 hours and 3 hours respectively and also the urinary incontinance between the catheterisations improved. At patient satisfactions, 78% of patients declared that they were pleased and underwent the procedure again and will recommend it to their relatives with similar problems. One patient had a complication as tansient weakness on her legs. Conclusion: BTX-A injections provide an alternative treatment before surgery at overactive bladder especially for those who doesn't response to medical treatment or cannot use antimuscarinics because of their side effects. Further studies with a greater number of patients are needed for determining the effectiveness of BTX-A on patients with voiding dysfunctions.

show abstract