title: [The effect of botulinum toxin injection into the bladder for overactive bladder: two case].
abstract: Two cases of intractable overactive bladder which were treated by intradetrusor botulinum-A toxin (BTX-A) are presented. Case 1: A 53-year-old woman suffered from adhesive arachinoiditis. She had severe detrusor hyperreflexia and urge urinary incontinence despite a high dose of anticholinergic medication. Under cystoscopic control, a total of 300 units of BTX-A were injected into the detrusor muscle at 30 sites (10 units per ml per site), sparing the trigone area using a 27G flexible injection needle. This procedure was done under both caudal anesthesia with 10 ml 1% lidocaine and bladder mucosa anesthesia by instilling 40 ml 2% lidocaine. At a 12-week followup she was completely continent. Case 2: A 63-year-old man with intractable detrusor overactivity of idiopathic origin was treated using the above technique. Urge urinary incontinence decreased 4 weeks after the BTX-A injections. However, postvoid residual urine volume was increased, and intermittent self-catheterization was needed. Intradetrusor BTX-A dramatically increases the bladder capacity and decreases the frequency of urge urinary incontinence. However, this treatment caused urinary retention in Case 2. We believe that the dosage amount of BTX-A should be changed case by case.
authors.affiliation: Department of Urology, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Motoaki
authors.initials: M
authors.lastname: Saito
authors.forename: Shinji
authors.initials: S
authors.lastname: Hirakawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Miyagawa
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D001743:Urinary Bladder; D014549:Urinary Incontinence / Q000188:drug therapy*
chemical_list: D019274:Botulinum Toxins, Type A