Refractory neurogenic detrusor overactivity.
Refractory neurogenic detrusor overactivity refers to the clinical condition that is no longer manageable by anticholinergic therapy. This condition represents a formidable task to caregivers because the treatment of urinary incontinence and adequate protection of the upper urinary tract become extremely difficult. Treatment options for refractory neurogenic detrusor overactivity include detrusor injections of botulinum toxin and intravesical instillation of vanilloid compounds, mainly resiniferatoxin, or anticholinergic drugs. If these options fail, bladder augmentation or sacral anterior root stimulation offers excellent outcomes, although at much higher costs and risks to the patients.
Cruz
F
F
Department of Urology, Hospital São João and Faculty of Medicine of Porto, Porto, Portugal. cruzfjmr@med.up.pt
Silva
C
C
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004224:Diterpenes / Q000627:therapeutic use; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use; D009498:Neurotoxins / Q000627:therapeutic use; D017211:Treatment Failure; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000601:surgery; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000601:surgery
D018680:Cholinergic Antagonists; D004224:Diterpenes; D009465:Neuromuscular Agents; D009498:Neurotoxins; C024353:resiniferatoxin; D019274:Botulinum Toxins, Type A