Botulinum Toxin A Intradetrusor Injection for Treating Neurogenic Detrusor Overactivity, A Single Centre Experience.
Autor: | Mosli HA; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia., Awad MA; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia., Rezk MM; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia., Alsabban AE; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia., Tayib AM; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia., Abdulwahab MH; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia., Assiri MA; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia. |
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Jazyk: | angličtina |
Zdroj: | Lower urinary tract symptoms [Low Urin Tract Symptoms] 2014 Sep; Vol. 6 (3), pp. 162-6. Date of Electronic Publication: 2013 Oct 24. |
DOI: | 10.1111/luts.12034 |
Abstrakt: | Objectives: To evaluate the efficacy and safety of Botulinum Toxin A (BoNTA) intradetrusor injections in patients with neurogenic detrusor overactivity. Methods: All patients provided clinical history and voiding diary, submitted to clinical examination, urine culture; serum creatinine; imaging, including plain abdominal X-rays, abdomino-pelvic ultrasonography and voiding cystourethrogram; and urodynamic tests (CMG) . They were managed by intradetrusor injections of BoNTA. For the typical patient, 300 units of BoNTA were injected through 30 injections of 10 u/mL intradetrusally into equally spaced sites of the bladder wall, excluding the trigone, under cystoscopic guidance. Patients were commenced clean intermittent catheterizations (CICs) every 4-6 h post-injection. Follow up included voiding diaries, abdomino-pelvic ultrasonography, serum creatinine and CMG, were completed for all patients at 6 and 12 weeks. This study used IBM SPSS Version 20.0 for statistical analysis. Results: Forty-five patients (28 males and 17 females) with a mean age of 19.6 years were subjected to BoNTA intradetrusor injections. A good clinical response (dry patient either completely or more than 50% of the period between CICs) was observed in 68.9 and 66.7% of the patients after 6 and 12 weeks of follow up, respectively. In the group that responded well, the mean bladder volume increased post-injection by 48.2% and the mean maximum intravesical pressure decreased to 35.3 cm H2 O, a 33.4% improvement. No patients had side-effects related to BoNTA or to the procedure, and no patients experienced a deterioration of their renal functions. Conclusions: Intradetrusor BoNTA injections provide a good clinical response. The urodynamic parameters significantly improved in patients with neurogenic detrusor overactivity. (© 2013 Wiley Publishing Asia Pty Ltd.) |
Databáze: | MEDLINE |
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