Botulinum Toxin Into the Trigone in Neurogenic Overactive Bladder Non-Responder to Detrusor Injection

Citeri, M.; Spinelli, M.; Zanollo, L.; Scroppo, Fabrizio Ildefonso; macrellino, elena; Redaelli, Tiziana

doi:10.1016/s1569-9056(08)60567-9

Cited by 5 publications

(6 citation statements)

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“…We also noticed our results similar to the preview studies [6][7][8][9][10][11][12]. One study found that not one of their 24 adults with OAB refractory to anticholinergic treatment who received trigoneinjection of BTX-A developed VUR during at 6-month follow-up [6].…”

Section: Discussionsupporting

confidence: 88%

“…One study found that not one of their 24 adults with OAB refractory to anticholinergic treatment who received trigoneinjection of BTX-A developed VUR during at 6-month follow-up [6]. A similar result was obtained in 10 women 6 weeks after treatment [7]. Interestingly, Kuo [8] found that the degree of renal hydronephrosis decreased with treatment in four of the five patients with baseline hydronephosis after injection.…”

Section: Discussionmentioning

confidence: 81%

“…In the past ten years, intradetrusor injection of BTX-A was performed while avoiding the trigone to prevent VUR. To our knowledge, several studies reported satisfactory clinical results about combined detrusor-trigone BTX-A injections [6][7][8][9][10][11][12]. However, most of these studies were small and single-center experience.…”

Section: Introductionmentioning

confidence: 99%

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Video-urodynamic Improvement of Trigonal BTX-A Injection for Patients with Poor Bladder Compliance Secondary to Spinal Cord Injury

Zhuocheng¹,

Chen²,

Xh³

et al. 2018

AJMCR

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 81%

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Video-urodynamic Improvement of Trigonal BTX-A Injection for Patients with Poor Bladder Compliance Secondary to Spinal Cord Injury

Zhuocheng¹,

Chen²,

Xh³

et al. 2018

AJMCR

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“…Similar results were reported by others. [12][13][14][15][16][17][18] Furthermore, one study reported that one patient with VUR (grade 2 right, grade 1 left) at baseline showed no change in VUR grade after trigone-including injections (100 U BTX-A). 19 Moreover, Mascarenhas Fone and his colleagues even observed one patient with grade II unilateral VUR had complete resolution of the reflux after total 300 U BTX-A injection into detrusor including 50 U BTX-A into the trigone.…”

Section: Discussionmentioning

confidence: 99%

“…Until now, many studies showed that the risk of VUR after trigonal BTX-A injection is a nonexistent risk. [12][13][14][15][16][17][18][19] Furthermore, Abdel-Meguid TA reported trigone-including injections are superior to trigone-sparing injections for the treatment of pharmacologically refractory idiopathic detrusor overactivity. 20 A recent review revealed most data for studies on detrusor overactivity with very little data on poor BC.…”

Section: Introductionmentioning

confidence: 99%

A single-blind randomized control trial of trigonal versus nontrigonal Botulinum toxin-A injections for patients with urinary incontinence and poor bladder compliance secondary to spinal cord injury

Chen

Xie

Jiang³

2020

The Journal of Spinal Cord Medicine

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Objective: To evaluate the effect of trigonal Botulinum toxin-A (BTX-A) injections on patients with urinary incontinence (UI) and poor bladder compliance (BC) secondary to spinal cord injury (SCI). Design: A single-blind randomized control trial. Setting: Department of urology in three hospitals. Participants: SCI patients with UI and poor BC were randomly assigned to either the experimental group or the control group. Interventions: The experimental group received an injection of 240 U BTX-A into the detrusor plus 60 U BTX-A into the trigone, while the control group received 300 U BTX-A into the detrusor sparing the trigone. Outcome Measures: Video urodynamic outcomes, including vesicoureteric reflux (VUR), detrusor leak point pressure (DLPP), and detrusor leak point volume (DLPV), were measured at baseline and week 12. UI episodes, voiding volume, and Incontinence Quality of Life (I-QoL) were assessed at baseline, week 2, 4, 8 and 12. Results: No patient reported new-onset VUR. Compared with baseline data, a significant improvement was achieved in both groups, whereas compared with DLPP and DLPV, a significant difference was noted between the two groups 12 weeks after injection. In the experimental group, the improvement of mean weekly UI episodes, voiding volume, and I-QoL were significantly better than those in the control group at 4, 8, and 12 weeks, respectively (all P < 0.05). Systemic complications of BTX-A injection were not reported. Conclusion: Trigonal BTX-A injection is more effective and safer than nontrigonal BTX-A injection for SCI patients with UI secondary to neurogenic-poor BC and does not result in VUR.

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Intravesical strategies to manage the neurogenic bladder

Dinis¹,

Cruz

2008

Curr Bladder Dysfunct Rep

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Intravesical therapy with botulinum toxin type A (BTX-A) and vanilloids (capsaicin and resiniferatoxin) are actively investigated as potential treatments for lower urinary tract symptoms refractory to conventional therapy in patients with neurogenic detrusor overactivity. BTX-A cleaves soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins in afferent and efferent nerve endings, impeding the fusion of synaptic vesicles with the neuronal membrane necessary for the release of neurotransmitters. Vanilloids desensitize the transient receptor potential vanilloid type 1 receptor and inactivate C-fi bers. BTX-A intradetrusor injections are extremely effective for treating urinary incontinence, provide adequate protection of the upper urinary tract, and improve quality of life in patients with neurogenic detrusor overactivity. Therefore, BTX-A is currently the mainstay of intravesical therapy. However, despite promising results overall, the administration of these compounds, including BTX-A, remains an experimental procedure requiring further clinical studies.

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Botulinum Toxin Into the Trigone in Neurogenic Overactive Bladder Non-Responder to Detrusor Injection

Cited by 5 publications

References 0 publications

Video-urodynamic Improvement of Trigonal BTX-A Injection for Patients with Poor Bladder Compliance Secondary to Spinal Cord Injury

Video-urodynamic Improvement of Trigonal BTX-A Injection for Patients with Poor Bladder Compliance Secondary to Spinal Cord Injury

A single-blind randomized control trial of trigonal versus nontrigonal Botulinum toxin-A injections for patients with urinary incontinence and poor bladder compliance secondary to spinal cord injury

Intravesical strategies to manage the neurogenic bladder

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