title: Effect of intravesical botulinum neurotoxin-A injection on detrusor hyperreflexia in spinal cord injured patients.
abstract: OBJECTIVE
  To evaluate the effects of Botulinum Toxin A injection into the detrusor muscle on various voiding parameters in spinal cord injured patients with neurogenic detrusor hyperreflexia Materials and methods: 24 patients with spinal cord injuries who had detrusor overactivity and urinary incontinence and were refractory to oral medications, were injected 300 IU of BTX-A into the detrusor muscle. The pre-and post-treatment evaluations included determination of bladder urinary continence status, frequency/volume chart of CIC, Incontinence Quality of Life questionnaire (I-QOL) and patient satisfaction. The urodynamic parameters measured included maximum cystometric capacity (MCC), reflex detrusor volume (RDV) and maximum detrusor pressure during bladder contraction (MDP) were analyzed at the outset and during the follow-up (2, 6, and 24 weeks) examinations.
  
  
  RESULTS
  The evaluation of urodynamic parameters during follow-up examinations (2, 6 and 24 weeks) revealed significant increase in mean reflex volume (p<0.05) and cystometric capacity (p<0.05), on the other detrusor pressure decreased significantly (p<0.05). In majority of patients there was considerable reduction in incontinence episodes and no complications or side effects were reported. Most of the patents were satisfied with the treatment.
  
  
  CONCLUSIONS
  The use of Botulinum toxin type A for treatment of neurogenic detrusor overactivity in spinal cord injured patients is safe and efficacious. In our 24-week study period, there was significant improvement in most urodynamic parameters with consistence and subjective satisfaction indicated by the treated patients.
authors.affiliation: Department of Orthopaedics, People's Hospital of Rizhao, Rizhao, China.
authors.forename: X-T
authors.initials: XT
authors.lastname: Ge
authors.affiliation: Department of Orthopaedics Surgery, Jinling Hospital, Southern Medical University, School of Medicine, Nanjing, China.
authors.forename: Y-F
authors.initials: YF
authors.lastname: Li
authors.affiliation: Department of Orthopaedics Surgery, Jinling Hospital, Southern Medical University, School of Medicine, Nanjing, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics Surgery, Jinling Hospital, Southern Medical University, School of Medicine, Nanjing, China.
authors.forename: J-N
authors.initials: JN
authors.lastname: Zhao
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D009132:Muscles / Q000187:drug effects; D011788:Quality of Life; D012021:Reflex, Abnormal / Q000187:drug effects*; D013116:Spinal Cord / Q000187:drug effects*; D013119:Spinal Cord Injuries / Q000188:drug therapy*; D001743:Urinary Bladder / Q000187:drug effects; D053201:Urinary Bladder, Overactive / Q000188:drug therapy; D014549:Urinary Incontinence / Q000188:drug therapy; D014563:Urodynamics / Q000187:drug effects
chemical_list: D019274:Botulinum Toxins, Type A