Botulinum A toxin treatment of urethral sphincter pseudodyssynergia in patients with cerebrovascular accidents or intracranial lesions

Urologia Internationalis
Yue Hwa Chen, Hann-Chorng Kuo

Abstract

Detrusor overactivity and urethral sphincter pseudodyssynergia may develop during recovery from cerebrovascular accidents or intracranial lesions, resulting in difficulty in urination, a large amount of residual urine, and recurrent urinary tract infection. This study evaluated the effectiveness of urethral injection of botulinum A toxin in treating these patients. Twenty-one patients with chronic cerebrovascular accidents or intracranial lesions and difficult urination were enrolled. Patients participating in the study elected to receive either 100 units of botulinum A toxin (n = 11) or served as medically treated controls (n = 10). The urodynamic parameters and voiding efficiency after treatment were compared between the 2 groups. An excellent result was obtained in 6 patients and an improved result in 4 patients, resulting in an overall success rate of 91% in the study group. Four patients with frank urinary retention before treatment resumed spontaneous voiding. The maximal effects of botulinum A toxin appeared about 2 weeks after treatment. The voiding pressure decreased (57.8 +/- 35.2 vs. 33.8 +/- 16.9 cm H2O, p = 0.005) and the maximal flow rate increased (7.2 +/- 5.9 vs. 10.3 +/- 5.2 ml/s, p = 0.005) significantly. In t...Continue Reading

Citations

Sep 21, 2007·Current Urology Reports·H Henry Lai, Christopher P Smith
May 28, 2009·Toxicon : Official Journal of the International Society on Toxinology·Mitchell F Brin
May 11, 2012·International Journal of Urology : Official Journal of the Japanese Urological Association·Yue-Chen Kuo, Hann-Chorng Kuo
Aug 12, 2015·Nature Reviews. Urology·Yuan-Hong JiangHann-Chorng Kuo
May 26, 2018·Neurourology and Urodynamics·Yuan-Hong JiangHann-Chorng Kuo
Aug 2, 2017·Ci Ji Yi Xue Za Zhi = Tzu-chi Medical Journal·Hann-Chorng Kuo
Oct 5, 2021·Neurourology and Urodynamics·Ching-Hsiang ChiangHann-Chorng Kuo

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