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

Abstract

Botulinum-A toxin injections into the detrusor seem to be a safe and valuable therapeutic option in spinal cord injured patients with incontinence resistant to anticholinergic medication who perform clean intermittent self-catheterization. Successfully treated patients become continent again and may withdraw from or markedly decrease anticholinergic drug intake. A dose of 300 units botulinum-A toxin seems to be needed to counteract an overactive detrusor. The duration of bladder paresis induced by the toxin is at least 9 months, when repeat injections are required.

Controversy over the pharmacological treatments of storage symptoms in spinal cord injury patients: a literature overview

“…Local BTX injections are effective in the treatment of muscular disorders and unlicensed botulinum toxin A (BTXA) has been successfully used to treat NLUTS. [19][20][21] BTX is thought to cleave SNAP-25, a synaptosome-associated protein, thereby blocking presynaptic acetylcholine release at the neuromuscular junction. This leads to temporary chemodenervation and muscle relaxation.…”

Botulinumtoxin in der Urologie

“…open-label Studien (Bagi and Biering-Sorensen, 2004;Del Popolo et al, 2008;Giannantoni et al, 2006b;Giannantoni et al, 2004b;Grosse et al, 2005;Hajebrahimi et al, 2005;Harper et al, 2003;Kalsi et al, 2008;Kalsi et al, 2006a;Kalsi et al, 2007;Kalsi et al, 2006b;Karsenty et al, 2006b;Kennelly and Kang, 2003;Kessler et al, 2005a;Klaphajone et al, 2005;Kuo, 2004;Kuo, 2006a;Popat et al, 2005;Reitz et al, 2007;Ruffion et al, 2006;Schulte-Baukloh et al, 2006b;Schurch et al, 2000; (Abrams et al, 2002). Obwohl der Symptomenkomplex in jedem Alter auftreten kann, steigt die Prävalenz mit dem Alter und ist höher bei Frauen als bei Männern (Milsom et al, 2001;Milsom et al, 2000).…”

“…Die systemische Nebenwirkunsrate in unserem Kollektiv war zu vernachlässigen, und wir können folglich die diesbezüglich gute Erfahrung anderer, die derartige Injektionstherapien durchführen, teilen (Chancellor et al, 2003;Ghalayini and Al-Ghazo, 2007;Ghei et al, 2005;Jeffery et al, 2007;Kessler et al, 2005a;Kuo, 2003a;Kuo, 2004;Kuo, 2005a;Popat et al, 2005;Sahai et al, 2007;Schmid et al, 2006;Schurch et al, 2000). (Flynn et al, 2004;Ghalayini and Al-Ghazo, 2007;Harper et al, 2003;Jeffery et al, 2007;Kalsi et al, 2008;Kalsi et al, 2006a;Kalsi et al, 2006b;Karsenty et al, 2007;Kessler et al, 2005a;Kuo, 2004;Kuo, 2005a;Lee et al, 2007;Lucioni et al, 2006;Popat et al, 2005;Rajkumar et al, 2005;Rapp et al, 2004;Schmid et al, 2006;Schulte-Baukloh et al, 2005c;Schulte-Baukloh et al, 2005d;Werner et al, 2005)) oder BoNT/B (zwei Studien: (Dykstra et al, 2003a;Hirst et al, 2007) 10.2.)…”

Botulinum toxin for treatment of urinary incontinence due to detrusor overactivity: a systematic review of effectiveness and adverse effects

“…[3][4][5] Preliminary non-randomized studies have recently investigated botulinum toxin (BTX) injected into the detrusor muscle as an agent to treat NDO. 6,7 BTX is a naturally occurring potent neurotoxin produced by Clostridium botulinum bacterium. BTX type A has been used successfully to treat spasmodic or dystonic neuromuscular diseases including cerebral palsy, hemifacial spasm, blepharospasm and cervical dystonia by inhibiting acetylcholine mediated muscle contraction and symptomatic spasm.…”