Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions

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...

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Main Authors: Jakkrit Klaphajone, Wasuwat Kitisomprayoonkul, Supon Sriplakit
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/62235
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spelling th-cmuir.6653943832-622352018-09-11T09:25:42Z Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions Jakkrit Klaphajone Wasuwat Kitisomprayoonkul Supon Sriplakit Health Professions Medicine 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. © 2005 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. 2018-09-11T09:24:10Z 2018-09-11T09:24:10Z 2005-11-01 Journal 00039993 2-s2.0-27644558616 10.1016/j.apmr.2005.06.008 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=27644558616&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/62235
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Health Professions
Medicine
spellingShingle Health Professions
Medicine
Jakkrit Klaphajone
Wasuwat Kitisomprayoonkul
Supon Sriplakit
Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
description 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. © 2005 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
format Journal
author Jakkrit Klaphajone
Wasuwat Kitisomprayoonkul
Supon Sriplakit
author_facet Jakkrit Klaphajone
Wasuwat Kitisomprayoonkul
Supon Sriplakit
author_sort Jakkrit Klaphajone
title Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
title_short Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
title_full Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
title_fullStr Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
title_full_unstemmed Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
title_sort botulinum toxin type a injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=27644558616&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/62235
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