Article

OBJECTIVE: To evaluate the effects of transrectal ultrasound-guided trocar
catheter transurethral botulinum toxin A (BTX-A) injection into the external
urethral sphincter (EUS) for treating detrusor external sphincter dyssynergia
(DESD) in men with spinal cord injury (SCI). DESIGN: Descriptive study. SETTING:
Hospital rehabilitation department. PARTICIPANTS: Patients (N=15; mean age,
40.5y; range, 22-64y) with suprasacral SCI with confirmed DESD determined by
urodynamic study. INTERVENTIONS: A single dose of 100U BTX-A was injected into
the EUS via transrectal ultrasound-guided trocar catheter transurethral
injection. MAIN OUTCOME MEASURES: Maximal detrusor pressure, detrusor leak point
pressure, maximal pressure on static urethral pressure profilometry, postvoid
residual volume, and maximal flow rate. RESULTS: After BTX-A transurethral
injection, 4 (28.5%) patients showed an excellent result and 7 (46.7%) patients
showed an improved result, whereas 4 (28.5%) patients experienced treatment
failure. The overall success rate was 75.2%. We observed a significant decrease
in static urethral pressure (P<.05) and detrusor leak point pressure after
treatment (P<.05), but not in detrusor pressure. The postvoid residual volume
were significantly decreased in the fourth week after treatment (P<.05).
CONCLUSIONS: Transrectal ultrasound-guided trocar catheter transurethral BTX-A
injection into the EUS effectively suppresses or ameliorates DESD. A potential
advantage of the method is that ultrasound guidance may not be necessary in the
next injection.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS