title: Botulinum toxin type A injection for neurogenic detrusor overactivity: clinical outcome in Japanese patients.
abstract: OBJECTIVE
  To report our experience with intravesical injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis.
  
  
  METHODS
  Between January 2003 and March 2011, 11 patients (aged 23-75 years) were treated with 40 injections of botulinum toxin type A 300 U. The patients were followed up for 4, 8 and 12 weeks after treatment. The King's Health Questionnaire was administered and cystometric studies were carried out at baseline and 8 weeks after treatment.
  
  
  RESULTS
  A total of six women and five men were treated. Analysis of the King's Health Questionnaire showed a significant improvement in eight of the nine domain scores at 8 weeks from baseline. On cystometric studies, the mean maximum cystometric capacity increased significantly in all patients at 8 weeks from baseline (P < 0.001). Bladder compliance also increased significantly (P < 0.001). The number of urinary incontinence episodes per day improved significantly from baseline after injection (4 weeks, P < 0.001; 8 weeks, P < 0.001; 12 weeks, P < 0.001). Lack of efficacy appeared 7.15 ± 3.4 months after treatment.
  
  
  CONCLUSIONS
  Injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis consistently improves bladder control and quality of life.
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Hikita
authors.forename: Masashi
authors.initials: M
authors.lastname: Honda
authors.forename: Bunya
authors.initials: B
authors.lastname: Kawamoto
authors.forename: Tsounapi
authors.initials: T
authors.lastname: Panagiota
authors.forename: Seiya
authors.initials: S
authors.lastname: Inoue
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hinata
authors.forename: Kuniyasu
authors.initials: K
authors.lastname: Muraoka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takenaka
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D044466:Asian People; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D007564:Japan; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000209:etiology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A