Article

The aim of this study was to compare the results of a transrectal
ultrasound-guided botulinum toxin injection with those of a cystoscopy-guided
method to the external urethral sphincter in treating detrusor external sphincter
dyssynergia. DESIGN:
A total of 18 suprasacral spinal cord-injured patients with
detrusor external sphincter dyssynergia were included in the present study. A
single dose of 100 IU botulinum toxin A was applied into the external urethral
sphincter via a transrectal ultrasound-guided transperineal route. We
retrospectively compared the outcome measurements with 20 suprasacral spinal
cord-injured patients previously treated with the same dose of botulinum toxin
through a cystoscopy-guided procedure. RESULTS: There were significant reductions
in integrated electromyography and urethral pressure but not in detrusor pressure
and leak point pressure after treatment. Postvoiding residuals were significantly
decreased in the first, second, and third months in the cystoscopy group and in
the first and second months in the transrectal ultrasound group. There were no
significant differences between the groups in all of the outcome measures.
CONCLUSIONS: This study demonstrates that transrectal ultrasound-guided
transperineal botulinum toxin injection may be an alternative for a cystoscopy-guided injection. This alternative procedure provides clinicians with
an innovative and less invasive method that is performed without requiring
anesthesia or cystoscopy.

Langue : ANGLAIS