title: [Botulinum A toxin and detrusor sphincter dyssynergia: retrospective study of 47 patients].
abstract: BACKGROUND
  To assess the efficacy of injections of botulinum toxin type A (BT-A) in the urethral sphincter for treating detrusor sphincter dyssynergia (DSD).
  
  
  METHODS
  Retrospective observational study of patients with confirmed urodynamic DSD (neurological and non-neurological etiologies) treated at our center from 2002 to 2010. All patients received 300 IU of DYSPORT® injected transperineally under electromyographic control. Using a visual analog scale (VAS) for mictional disorders and the measure of the post-void residual (PVR) as criteria of efficacy, results were classified as "non-satisfactory" (decrease in the VAS<2 or decrease in the PVR<20%), "intermediate" (decrease in the VAS≥2 or decrease in the PVR≥20%) or "satisfactory" (decrease in the VAS>3 or decrease in the PVR>40%).
  
  
  RESULTS
  Records of 47 patients (7 women and 40 men) were studied. Mean follow-up was 14.2 months. At the end of follow-up, there were 23.4% (11) of "satisfactory" results, 19.1% (9) of "intermediate" results, 42.6% (20) of "non-satisfactory" results and 14.9% (7) of patients lost for follow-up. The mean decrease in PVR was 60 mL (from an average of 212 to an average of 152 mL). No side effect was observed.
  
  
  CONCLUSIONS
  In this small series reporting the results of the injection of BT-A in the urethral sphincter for DSD, we observed 42.5% of satisfactory or intermediate results without associated side effects.
authors.affiliation: Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France. Electronic address: hocine.habchi@chu-st-etienne.fr.
authors.forename: H
authors.initials: H
authors.lastname: Habchi
authors.affiliation: Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Galaup
authors.affiliation: Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
authors.forename: N
authors.initials: N
authors.lastname: Morel-Journel
authors.affiliation: Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 8, France.
authors.forename: A
authors.initials: A
authors.lastname: Ruffion
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001259:Ataxia / Q000188:drug therapy*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D014521:Urethra; D014522:Urethral Diseases / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin type A; Detrusor external sphincter dyssynergia; Dyssynergie vésico-sphinctérienne; Toxine botulique type A; Urethra; Urètre
vernacular_title: Toxine botulique A et dyssynergie vésico-sphinctérienne : étude rétrospective portant sur 47 patients.