Botulinum-A toxin as a treatment of detrusor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients.
OBJECTIVE
The paralytic effect of botulinum-A toxin injections on the external urethral sphincter was investigated prospectively in patients with neurogenic voiding disorders.


METHODS
Transurethral versus transperineal botulinum-A toxin injections were performed in 24 spinal cord injury male patients with detrusor-sphincter dyssynergia and the respective efficacy was compared.


RESULTS
In 21 of 24 patients detrusor-sphincter dyssynergia was significantly improved with a concomitant decrease in post-void residual volumes in most cases. Botulinum-A toxin effects lasted 3 to 9 months, making reinjections necessary.


CONCLUSIONS
Although costly, botulinum-A toxin injections, which aim at suppressing detrusor-sphincter dyssynergia but not bladder neck dyssynergia, appear to be a valid alternative for patients who do not desire surgery or are unable to perform self-catheterization.
Schurch
B
B
Swiss Paraplegic Centre, Clinic Balgrist, Zurich University, Switzerland.
Hauri
D
D
Rodic
B
B
Curt
A
A
Meyer
M
M
Rossier
A B
AB
D000293:Adolescent; D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage*; D001905:Botulinum Toxins / Q000008:administration & dosage*; D003558:Cystoscopy; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D010502:Perineum; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D014521:Urethra; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins