title: Botulinum Toxin A Intradetrusor Injection for Treating Neurogenic Detrusor Overactivity, A Single Centre Experience.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of Botulinum Toxin A (BoNTA) intradetrusor injections in patients with neurogenic detrusor overactivity.
  
  
  METHODS
  All patients provided clinical history and voiding diary, submitted to clinical examination, urine culture; serum creatinine; imaging, including plain abdominal X-rays, abdomino-pelvic ultrasonography and voiding cystourethrogram; and urodynamic tests (CMG) . They were managed by intradetrusor injections of BoNTA. For the typical patient, 300 units of BoNTA were injected through 30 injections of 10 u/mL intradetrusally into equally spaced sites of the bladder wall, excluding the trigone, under cystoscopic guidance. Patients were commenced clean intermittent catheterizations (CICs) every 4-6 h post-injection. Follow up included voiding diaries, abdomino-pelvic ultrasonography, serum creatinine and CMG, were completed for all patients at 6 and 12 weeks. This study used IBM SPSS Version 20.0 for statistical analysis.
  
  
  RESULTS
  Forty-five patients (28 males and 17 females) with a mean age of 19.6 years were subjected to BoNTA intradetrusor injections. A good clinical response (dry patient either completely or more than 50% of the period between CICs) was observed in 68.9 and 66.7% of the patients after 6 and 12 weeks of follow up, respectively. In the group that responded well, the mean bladder volume increased post-injection by 48.2% and the mean maximum intravesical pressure decreased to 35.3 cm H2 O, a 33.4% improvement. No patients had side-effects related to BoNTA or to the procedure, and no patients experienced a deterioration of their renal functions.
  
  
  CONCLUSIONS
  Intradetrusor BoNTA injections provide a good clinical response. The urodynamic parameters significantly improved in patients with neurogenic detrusor overactivity.
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Hisham A
authors.initials: HA
authors.lastname: Mosli
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mohannad A
authors.initials: MA
authors.lastname: Awad
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mamdouh M
authors.initials: MM
authors.lastname: Rezk
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abdulrahman E
authors.initials: AE
authors.lastname: Alsabban
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abdulmalik M S
authors.initials: AM
authors.lastname: Tayib
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Abdulwahab
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Moayad A
authors.initials: MA
authors.lastname: Assiri
keywords: BoNTA; botulinum toxin; intradetrusor; neurogenic bladder; overactive bladder