title: Effects of botulinum toxin A injections in spinal cord injury patients with detrusor overactivity and detrusor sphincter dyssynergia.
abstract: OBJECTIVE
  To evaluate the safety and effect of botulinum toxin A injection in the detrusor and external urethral sphincter in male patients with detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) secondary to spinal cord injury.
  
  
  METHODS
  A multicentre trial was conducted from June 2012 to August 2015. A total of 65 spinal cord injury patients with DO and DESD participated in the study. Of these, 59 received 200 U botulinum toxin Aintradetrusor and 100 U external urethral sphincter injections. The effective outcomes included maximum detrusor pressure at first DO and DESD, VDO-DESD, maximum urethral closure pressure, duration of first DO and DESD, Incontinence-Specific Quality-of-Life Instrument, voiding volume, urinary incontinence episodes and complete dryness. Adverse events were recorded.
  
  
  RESULTS
  All patients experienced a significant mean reduction in PdetmaxDO -DESD (46.60%), maximum urethral closure pressure (29.61%), duration of first DO and DESD (42.93%) and a significant mean increase in VDO-DESD (38.11%) 12-weeks post-injection. Significant (p < 0.001) improvement in mean Incontinence-Specific Quality-of-Life Instrument, voiding volume, urinary incontinence episodes and complete dryness were found in all patients at 2 weeks and were sustained at 8 weeks and 16 weeks.
  
  
  CONCLUSIONS
  Botulinum toxin A injection in the detrusor and external urethral sphincter is an effective treatment to protect the upper urinary tract and improve quality of life for patients with DO and DESD secondary to spinal cord injury.
authors: Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital and Jinan University, Guangzhou, China.
authors: Maping
authors: M
authors: Huang
authors: Hui
authors: H
authors: Chen
authors: Chonghe
authors: C
authors: Jiang
authors: Keji
authors: K
authors: Xie
authors: Ping
authors: P
authors: Tang
authors: Rubiao
authors: R
authors: Ou
authors: Jiangwen
authors: J
authors: Zeng
authors: Qiuling
authors: Q
authors: Liu
authors: Qingqing
authors: Q
authors: Li
authors: Jiebing
authors: J
authors: Huang
authors: Tianhai
authors: T
authors: Huang
authors: Weiwei
authors: W
authors: Zeng
mesh_terms: D000328:Adult; D001259:Ataxia / Q000188:drug therapy* / Q000209:etiology; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology; D014522:Urethral Diseases / Q000188:drug therapy* / Q000209:etiology
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A