Biomaterial Database

Injections of Botulinum Toxin A into the detrusor to treat neurogenic detrusor overactivity secondary to spinal cord injury. 2011

Guoqing Chen, and Limin Liao

Department of Urology, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University, 100068 Beijing, China.

BACKGROUND To present a comprehensive experience of botulinum toxin A (BTX-A) injected into the detrusor muscle in patients with spinal cord injuries (SCI) causing neurogenic detrusor overactivity. METHODS Three hundred units of BTX-A were injected cystoscopically into the detrusor muscle of 108 patients with neurogenic detrusor overactivity secondary to SCI at 30 different locations. Evaluations were performed before the injections and 6 weeks after, and they included determination of bladder urinary continence status, frequency/volume chart of CIC, concomitant anticholinergic medication use, Incontinence Quality of Life questionnaire (I-QOL) and patient satisfaction. Key urodynamic parameters (reflex volume, maximum detrusor pressure during voiding, detrusor compliance and maximum cystometric capacity) were analyzed at the outset and during the follow-up (6, 12 and 36 weeks) examinations. RESULTS By the time of the urodynamic follow-up examinations (6, 12 and 36 weeks), the mean cystometric capacity (P < 0.05) and the mean reflex volume (P < 0.05) increased significantly, while the mean voiding pressure (P < 0.05) decreased significantly. No complications or side effects were reported. Most patients considerably reduced or even stopped taking anticholinergic drugs and were satisfied with the treatment. CONCLUSIONS This retrospective study indicates that BTX-A injections into the detrusor muscle to treat neurogenic detrusor overactivity secondary to SCI are safe and valuable. Significant improvement of bladder function corresponded with continence and subjective satisfaction indicated by the treated patients.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009130	Muscle, Smooth	Unstriated and unstriped muscle, one of the muscles of the internal organs, blood vessels, hair follicles, etc. Contractile elements are elongated, usually spindle-shaped cells with centrally located nuclei. Smooth muscle fibers are bound together into sheets or bundles by reticular fibers and frequently elastic nets are also abundant. (From Stedman, 25th ed)	Muscle, Involuntary,Smooth Muscle,Involuntary Muscle,Involuntary Muscles,Muscles, Involuntary,Muscles, Smooth,Smooth Muscles
D009465	Neuromuscular Agents	Drugs used for their actions on skeletal muscle. Included are agents that act directly on skeletal muscle, those that alter neuromuscular transmission (NEUROMUSCULAR BLOCKING AGENTS), and drugs that act centrally as skeletal muscle relaxants (MUSCLE RELAXANTS, CENTRAL). Drugs used in the treatment of movement disorders are ANTI-DYSKINESIA AGENTS.	Skeletal Muscle Relaxants,Neuromuscular Effect,Neuromuscular Effects,Agents, Neuromuscular,Effect, Neuromuscular,Effects, Neuromuscular,Muscle Relaxants, Skeletal,Relaxants, Skeletal Muscle
D011788	Quality of Life	A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease.	HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D001743	Urinary Bladder	A musculomembranous sac along the URINARY TRACT. URINE flows from the KIDNEYS into the bladder via the ureters (URETER), and is held there until URINATION.	Bladder,Bladder Detrusor Muscle,Detrusor Urinae,Bladder Detrusor Muscles,Bladder, Urinary,Detrusor Muscle, Bladder,Detrusor Muscles, Bladder
D001750	Urinary Bladder, Neurogenic	Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.	Bladder Disorder, Neurogenic,Neurogenic Bladder,Bladder Neurogenesis,Bladder, Neurogenic,Neurogenic Bladder Disorder,Neurogenic Bladder, Atonic,Neurogenic Bladder, Spastic,Neurogenic Bladder, Uninhibited,Neurogenic Dysfunction of the Urinary Bladder,Neurogenic Urinary Bladder Disorder,Neurogenic Urinary Bladder, Atonic,Neurogenic Urinary Bladder, Spastic,Neurogenic Urinary Bladder, Uninhibited,Neuropathic Bladder,Urinary Bladder Disorder, Neurogenic,Urinary Bladder Neurogenesis,Urinary Bladder Neurogenic Dysfunction,Atonic Neurogenic Bladder,Neurogenesis, Bladder,Neurogenesis, Urinary Bladder,Neurogenic Bladder Disorders,Neurogenic Urinary Bladder,Spastic Neurogenic Bladder,Uninhibited Neurogenic Bladder
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths