Journal
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Volume 86, Issue 11, Pages 2114-2118Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2005.06.008
Keywords
bladder; neurogenic; botulinum toxin type A; muscle hypertonia; rehabilitation; spinal cord diseases
Categories
Ask authors/readers for more resources
Objective: To evaluate botulinum toxin type A (BTX-A) for treating neurogenic detrusor overactivity in patients with spinal cord lesions, including those with abnormally low bladder compliance. Design: Nonrandomized, before-after trial (9-mo follow-up). Setting: Hospitalized care. Participants: Ten patients with high detrusor contraction pressure and/or poor response to oxyphencyclimine with incontinence selected as a consecutive sample. Intervention: BTX-A (Botox; 300U) was injected into the detrusor muscle. Main Outcome Measures: Urinary continence, functional bladder capacity, bladder compliance, detrusor contraction pressure, and volume at first reflex voiding. Measurements were taken before and 6, 16, and 36 weeks posttreatment. Results: Six weeks after treatment, complete continence was restored in 7 patients without oxyphencyclimine. Mean functional bladder capacity (P=.008), compliance (P=.012), and reflex volume (P=.045) significantly increased, whereas maximal detrusor contraction pressure significantly decreased (P<.001). Urodynamic variables remained significantly improved at 16 weeks, but values were returning toward baseline levels by 36 weeks. The procedure was generally uneventful, without any serious side effects. Conclusions: BTX-A injections are an effective, well-tolerated treatment for neurogenic detrusor overactivity in patients with spinal cord lesions, even in patients with abnormally low bladder compliance. Patients may require repeat injections after 16 weeks to remain continent.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available