1161 BOTULINUM-A TOXIN URETHRAL SPHINCTER INJECTIONS TO RESTORE BLADDER VOIDING DYSFUNCTION

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy1 Apr 20111161 BOTULINUM-A TOXIN URETHRAL SPHINCTER INJECTIONS TO RESTORE BLADDER VOIDING DYSFUNCTION Daniel Max Schmid, Rachel Groebli-Bolleter, Sharmistha Roy-Guggenbuehl, and Tullio Sulser Daniel Max SchmidDaniel Max Schmid Zurich, Switzerland More articles by this author , Rachel Groebli-BolleterRachel Groebli-Bolleter Zurich, Switzerland More articles by this author , Sharmistha Roy-GuggenbuehlSharmistha Roy-Guggenbuehl Zollikerberg, Switzerland More articles by this author , and Tullio SulserTullio Sulser Zurich, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.771AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Aim of this prospective study was to evaluate the efficacy of Botulinum-A Toxin (BoNT-A) injections into the external urethral sphincter (EUS) in patients with neurogenic and non-neurogenic bladder outlet obstruction (DSD, pelvic floor spasticity) or hypocontractile detrusor, refractory to antispastic or £/-1-blocker therapy. METHODS 61 patients (41 m, 20 f; mean age 55 y; 36 non-neurogenic, 25 neurogenic) with voiding dysfunction (20 DSD, 32 pelvic floor spasticity, 9 hypocontractile detrusor) were treated by injections of 100 U BoNT-A (Botox,μ, Allergan) into the urethral rhabdosphincter (at the 12, 3, 6 & 9 o¡|clock positions) using a rigid cystoscope and a flexible injection needle. 18 pat. got additionally 100 U BoNT-A into the detrusor, due to coincident neurogenic OAB. All underwent pretreatment urodynamics, neurological status, cystoscopy and urine probes. Clinical and urodynamic checks were performed 6 weeks after treatment. RESULTS Postoperatively 80% of patients showed a significant improvement (p<0.05) of their voiding function regarding subjective symptoms (straining, micturition time, urine stream) and urodynamic parameters: maximum flow rate increased from mean 4.5 ml/s to 11.5 ml/s, whereas post-void residual decreased from mean 130 ml to 15 ml. The maximum micturition pressure decreased from mean 137 cmH2O to 63 cmH2O and the maximum urethral pressure at rest diminished from 131 cmH2O to 65 cmH2O. 4/6 patients who did intermittent catheterization were able to void spontaneously after BTX-treatment. QoL showed an increase of 3 up to 7.5 Pt. in a visual analogue scale (0–10). No side effects such as stress urinary incontinence or paralysis of remote muscles occured. Duration of the effect was mean 6 (+/- 2) months. So far, 25 % underwent repeated injections. CONCLUSIONS Urethral sphincter BoNT-A injections in male and female patients with complex voiding dysfunction are an encouraging efficient and safe alternative treatment to failing antispastic oral treatment. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e466 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Max Schmid Zurich, Switzerland More articles by this author Rachel Groebli-Bolleter Zurich, Switzerland More articles by this author Sharmistha Roy-Guggenbuehl Zollikerberg, Switzerland More articles by this author Tullio Sulser Zurich, Switzerland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...