title: Botulinum injections for the treatment of bladder symptoms of multiple sclerosis.
abstract: OBJECTIVE
  Our objective was to demonstrate the efficacy and impact on quality of life of detrusor injections of botulinum neurotoxin type A in the treatment of bladder dysfunction in patients with multiple sclerosis.
  
  
  METHODS
  Forty-three patients with multiple sclerosis suffering from severe urgency incontinence were treated with detrusor injections of botulinum neurotoxin type A. Data from cystometric assessment of the bladder, voiding diaries, quality-of-life questionnaires, and procontinence medication usage were collected before treatment and 4 and 16 weeks after injection. The same data were also collected after repeat treatments.
  
  
  RESULTS
  Highly significant improvements (p < 0.0001) in incontinence episodes and urinary urgency, daytime frequency and nocturia, were the symptomatic reflection of the significant improvements in urodynamically demonstrated bladder function. Although 98% of patients had to perform self-catheterization after treatment, there were sustained improvements in all quality-of-life scores. The mean duration of effect was 9.7 months. Similar results were seen with repeat treatments.
  
  
  CONCLUSIONS
  Minimally invasive injections of botulinum neurotoxin type A have been shown to be exceptionally effective in producing a prolonged improvement in urinary continence in patients with multiple sclerosis. This treatment is likely to have a major impact on future management.
authors: Institute of Neurology and Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors: Vinay
authors: V
authors: Kalsi
authors: Gwen
authors: G
authors: Gonzales
authors: Roshni
authors: R
authors: Popat
authors: Apostolos
authors: A
authors: Apostolidis
authors: Sohier
authors: S
authors: Elneil
authors: Prokar
authors: P
authors: Dasgupta
authors: Clare J
authors: CJ
authors: Fowler
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000818:Animals; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D051379:Mice; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
chemical_list: D019274:Botulinum Toxins, Type A