title: Treatment of detrusor external sphincter dyssynergia using ultrasound-guided trocar catheter transurethral botulinum toxin a injection in men with spinal cord injury.
abstract: OBJECTIVE
  To evaluate the effects of transrectal ultrasound-guided trocar catheter transurethral botulinum toxin A (BTX-A) injection into the external urethral sphincter (EUS) for treating detrusor external sphincter dyssynergia (DESD) in men with spinal cord injury (SCI).
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Hospital rehabilitation department.
  
  
  METHODS
  Patients (N=15; mean age, 40.5y; range, 22-64y) with suprasacral SCI with confirmed DESD determined by urodynamic study.
  
  
  METHODS
  A single dose of 100U BTX-A was injected into the EUS via transrectal ultrasound-guided trocar catheter transurethral injection.
  
  
  METHODS
  Maximal detrusor pressure, detrusor leak point pressure, maximal pressure on static urethral pressure profilometry, postvoid residual volume, and maximal flow rate.
  
  
  RESULTS
  After BTX-A transurethral injection, 4 (28.5%) patients showed an excellent result and 7 (46.7%) patients showed an improved result, whereas 4 (28.5%) patients experienced treatment failure. The overall success rate was 75.2%. We observed a significant decrease in static urethral pressure (P<.05) and detrusor leak point pressure after treatment (P<.05), but not in detrusor pressure. The postvoid residual volume were significantly decreased in the fourth week after treatment (P<.05).
  
  
  CONCLUSIONS
  Transrectal ultrasound-guided trocar catheter transurethral BTX-A injection into the EUS effectively suppresses or ameliorates DESD. A potential advantage of the method is that ultrasound guidance may not be necessary in the next injection.
authors.affiliation: Department of Rehabilitation, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China. Electronic address: weixinsuda@163.com.
authors.forename: Wei Xin
authors.initials: WX
authors.lastname: Yang
authors.affiliation: Department of Rehabilitation, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Zhu
authors.affiliation: Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Wei Guo
authors.initials: WG
authors.lastname: Chen
authors.affiliation: Department of Rehabilitation, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Da Wei
authors.initials: DW
authors.lastname: Zhang
authors.affiliation: Department of Rehabilitation, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Min
authors.initials: M
authors.lastname: Su
authors.affiliation: Department of Rehabilitation, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Jin Fa
authors.initials: JF
authors.lastname: Feng
authors.affiliation: Department of Rehabilitation, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Chuan Dao
authors.initials: CD
authors.lastname: Liu
authors.affiliation: Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Cai
mesh_terms: D000328:Adult; D001259:Ataxia / Q000188:drug therapy* / Q000209:etiology*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications*; D018084:Ultrasonography, Interventional; D014522:Urethral Diseases / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin type A; Rehabilitation; Ultrasonography; Urinary bladder; Urinary retention; Urodynamics