Intravesical injections of botulinum toxin type A for management of neuropathic bladder: a comparison of two methods

Urology
Saeed SafariAbdol-Mohammad Kajbafzadeh

Abstract

To evaluate and compare the efficacy of botulinum toxin intravesical injections with and without injections in external urethral sphincter in treating bladder hyper-reflexia in children suffering from myelomeningocele. A total of 60 patients with bladder hyper-reflexia due to myelomeningocele were randomly allocated to treatment groups A and B and were followed up for 6 months. Under cystoscopic guidance, 10 IU/kg of botulinum toxin A was injected into the detrusor muscle, sparing the trigone and ureteral orifices in group A. Group B received 8 IU/kg of toxin via the same method compared with group A and 2 IU/kg of toxin through 4 injections in external urethral sphincter. Conventional urodynamics, daily incontinence score, constipation, and creatinine level were evaluated at baseline, 3 months, and 6 months after intervention. Vesicoureteral reflux was also assessed before and after 3 months of injections. All patients showed significant improvement in bladder capacity (P <.01), maximal detrusor pressure (P <.01), and detrusor-sphincter dyssynergia (P <.01) after 3 and 6 months of receiving injections. Significant improvement in postvoiding residual volume was observed only among patients of group B (P <.05). Both methods resu...Continue Reading

References

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Citations

Nov 1, 2011·Current Urology Reports·Gregory E Dean, Christopher Long
Apr 30, 2011·The Journal of Urology·Maria Paola PascaliMario De Gennaro
Aug 12, 2015·Nature Reviews. Urology·Yuan-Hong JiangHann-Chorng Kuo
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Jun 12, 2019·International Urology and Nephrology·Riyad PeeraullyNia Fraser

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