A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging.

World Journal of Urology
Ulrich MehnertBrigitte Schurch

Abstract

Although botulinum neurotoxin type A (BoNT/A) intradetrusor injections are a recommended therapy for neurogenic detrusor overactivity (NDO), refractory to antimuscarinic drugs, a standardisation of injection technique is missing. Furthermore, some basic questions are still unanswered, as where the toxin solution exactly spreads after injection. Therefore, we investigated the distribution of the toxin solution after injection into the bladder wall, using magnet resonance imaging (MRI). Six patients with NDO were recruited. Three of six patients received 300 U of BoNT/A + contrast agent distributed over 30 injection sites (group 1). The other three patients received 300 U of BoNT/A + contrast agent distributed over 10 injection sites (group 2). Immediately after injection, MRI of the pelvis was performed. The volume of the detrusor and the total volume of contrast medium inside and outside the bladder wall were calculated. In all patients, a small volume (mean 17.6%) was found at the lateral aspects of the bladder dome in the extraperitoneal fat tissue, whereas 82.4% of the injected volume reached the target area (detrusor). In both groups there was a similar distribution of the contrast medium in the target area. A mean of 33.3 ...Continue Reading

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Citations

Feb 4, 2011·Expert Opinion on Pharmacotherapy·Apostolos Apostolidis
Jun 19, 2013·Neurourology and Urodynamics·Francisco Cruz
Aug 14, 2012·BJU International·Jens WöllnerUlrich Mehnert
Apr 1, 2010·BJU International·Yao-Chi ChuangMichael B Chancellor
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Mar 1, 2013·Journal of Clinical Urology·J H SethA Sahai
Apr 7, 2020·International Neurourology Journal·Vladimír ŠámalJan Mečl

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