Repeated Injection of Botulinum Toxin a in Patients with Neurogenic Bladder: Our Experience
| Autor: | Vito Lacetera, Ubaldo Cantoro, Francesco Catanzariti, Daniele Minardi, Giovanni Muzzonigro, Alessandro Conti |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
business.industry media_common.quotation_subject Residual urine Urology General Medicine urologic and male genital diseases Injections Intramuscular Urination Medium term Botulinum toxin a Urodynamics Neck of urinary bladder Urinary Incontinence medicine.anatomical_structure Neuromuscular Agents medicine Humans Sphincter Trigone of urinary bladder In patient Urinary Bladder Neurogenic business media_common |
| Zdroj: | Urologia Journal. 79:9-14 |
| ISSN: | 1724-6075 0391-5603 |
| DOI: | 10.5301/ru.2012.9383 |
| Popis: | BACKGROUND In literature, the majority of data about treatment with botulinum toxin A are based on the results of a single treatment. We evaluate the safety and effectiveness in the medium term of the use of botulinum toxin type A in patients with neurogenic bladder, taking into consideration the clinical and urodynamic parameters, particularly in cases with repeated injections. METHODS 25 patients were divided into 2 groups: a first group of patients with detrusor overactivity, and a second with overactive sphincter. We performed 20-30 injections (Dysport), at a dose ranging between 500 and 1000 U. The first group was treated with infiltration in the detrusor and in the detrusor and trigone. The second group received injections in the perisphinteric zone, and in the perisphinteric zone and bladder neck. Of the 25 patients, 12 received a retreatment: the first group of patients kept a daily voiding diary to record the number of bladder emptying, incontinence episodes, nycturia and urgency of urination. The urodynamic parameters and symptoms pre-treatment and 4 months after the treatment were compared in both groups. RESULTS In the first group there were significant changes in the cystometric capacity, maximum detrusor pressure, and in the post-void residual urine 4 months after treatment. These patients were satisfied with the treatment because of the improvement of incontinence and episodes of urgency. In 9 out of 15 retreated patients, the therapeutic results were similar to the first treatment. The second group reported significant improvements in maximum urinary flow rate, post-void residual urine and maximum detrusor pressure. 3 out of 10 patients were retreated even in this group; the new therapeutic results were similar to the first treatment. CONCLUSIONS Our results in 25 patients with neurogenic bladder showed a concordance with the literature data. The treatment of detrusor and sphincter neurogenic overactivity with botulinum toxin A is effective and safe. Also in the 12 patients with repeated injection treatment, it has been proven safe and effective. |
| Databáze: | OpenAIRE |
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