Article

OBJECTIVE: To evaluate the safety and effect of botulinum toxin A injection in
the detrusor and external urethral sphincter in male patients with detrusor
overactivity (DO) and detrusor external sphincter dyssynergia (DESD) secondary to
spinal cord injury. METHODS:
A multicentre trial was conducted from June 2012 to
August 2015. A total of 65 spinal cord injury patients with DO and DESD participated in the study. Of these, 59 received 200 U botulinum toxin
Aintradetrusor and 100 U external urethral sphincter injections. The effective
outcomes included maximum detrusor pressure at first DO and DESD, VDO-DESD,
maximum urethral closure pressure, duration of first DO and DESD,
Incontinence-Specific Quality-of-Life Instrument, voiding volume, urinary
incontinence episodes and complete dryness. Adverse events were recorded.
RESULTS: All patients experienced a significant mean reduction in PdetmaxDO -DESD
(46.60%), maximum urethral closure pressure (29.61%), duration of first DO and
DESD (42.93%) and a significant mean increase in VDO-DESD (38.11%) 12-weeks
post-injection. Significant (p < 0.001) improvement in mean Incontinence-Specific
Quality-of-Life Instrument, voiding volume, urinary incontinence episodes and
complete dryness were found in all patients at 2 weeks and were sustained at 8
weeks and 16 weeks. CONCLUSION: Botulinum toxin A injection in the detrusor and
external urethral sphincter is an effective treatment to protect the upper
urinary tract and improve quality of life for patients with DO and DESD secondary
to spinal cord injury.

Langue : ANGLAIS