Predict the Results of Botulinum Toxin-a Injection for the Treatment of Spinal Cord Injury Patients with Refractory Neurogenic Detrusor Overactivity ?

Content Provider	Semantic Scholar
Author	Silva, Joana Barbosa
Copyright Year	2011
Abstract	Study design, materials and methods Thirty nine patients with spinal cord injuries were evaluated prospectively. All patients emptied their bladder by clear intermittent catheterization, presented urinary incontinence despite using high doses of two different anticholinergics or association of oxybutinin oral and intravesical and underwent detrusor injection of botulinum toxin A (300 U). Pre-treatment assessment included urodynamic, ultrasonography of the kidneys and urinary tract and cystography. Follow-up consisted of urodynamic and outpatient consultation one month after and the clinical outcome was evaluated through outpatient consultations and telephone contact. The treatment was considered effective if a patient sustained 4 months without incontinence whether or not this occurred while using anticholinergic agents. Using cystography, the outcome was evaluated in relation to the bladder shape, bladder capacity, and diverticula presence. Bladder shape was characterized as either round, “pyriform” or “pine tree” shaped. Cystometric capacity was categorized as either very reduced (≤ 200 ml), decreased (from 200 to 399 ml) or normal (≥ 400 ml). The number of diverticula was either large, small, or absent. The present study is motivated by the observation that bladders evaluated by cystography and cystoscopy during the injection procedure revealed different characteristics that could influence the treatment outcome. In terms of shape, two major types have been identified: 1.) A normally-shaped bladder without any diverticula and 2.) An abnormally shaped bladder that is “pyriform” or “pine-tree” shaped and/or has a large number of diverticula.
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://www.ics.org/Abstracts/Publish/106/000749.pdf
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article