title: Successful treatment with intradetrusor Botulinum-A toxin for urethral urinary leakage (catheter bypassing) in patients with end-staged multiple sclerosis and indwelling suprapubic catheters.
abstract: OBJECTIVE
  To present the initial results of Botulinum-A toxin (BTA) injection in patients with long-standing multiple sclerosis (MS) and urethral leakage of urine in spite of indwelling suprapubic catheters (catheter bypassing).
  
  
  METHODS
  Study of three patients treated with cystoscopic injection of BTA IU (Allergan). Telephone interviews were made at four- to six-week intervals. Continence status and patient satisfaction were recorded before and after treatment.
  
  
  RESULTS
  Patient 1 remained dry at 48 weeks post injection. Patient 2 became incontinent again after 40 weeks. The third patient was continent when interviewed at 27 weeks following injection, but died two weeks later. The patients were very satisfied with the procedure and there were no complications related to BTA.
  
  
  CONCLUSIONS
  Intradetrusor BTA injection is a very effective and safe treatment for intractable catheter bypassing in patients with neurogenic detrusor overactivity.
authors.affiliation: Urology Department, Royal Bolton Hospital, Minerva Road, Farnworth, BL4 0JR, UK. elviralekka@hotmail.com
authors.forename: Elvira
authors.initials: E
authors.lastname: Lekka
authors.forename: Ling K
authors.initials: LK
authors.lastname: Lee
mesh_terms: D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D012074:Remission Induction; D014521:Urethra; D014546:Urinary Catheterization; D014549:Urinary Incontinence / Q000209:etiology* / Q000628:therapy*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A