1. Efficacy of Urethral Sphincter Botulinum Toxin A Injection in Patients with Spinal Cord Injury with Dysuria: A Retrospective Cohort Study.
- Author
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Yu WR, Tian JH, and Kuo HC
- Subjects
- Humans, Retrospective Studies, Male, Middle Aged, Adult, Female, Treatment Outcome, Aged, Neuromuscular Agents administration & dosage, Neuromuscular Agents therapeutic use, Young Adult, Injections, Urinary Bladder, Neurogenic drug therapy, Urinary Bladder drug effects, Botulinum Toxins, Type A administration & dosage, Botulinum Toxins, Type A therapeutic use, Spinal Cord Injuries drug therapy, Spinal Cord Injuries complications, Dysuria drug therapy, Dysuria etiology, Urethra drug effects
- Abstract
Spinal cord injury (SCI) often leads to neurogenic lower urinary tract dysfunction, causing dysuria and affecting patients' well-being. This study aimed to evaluate the efficacy of a urethral sphincter botulinum toxin A (BoNT-A) injection in patients with SCI and dysuria. This was a retrospective study including 118 patients with SCI who underwent a urethral BoNT-A injection following a standardized protocol for refractory voiding dysfunction. The protocol involved injecting BoNT-A into the urethral sphincter under cystoscopic guidance. Patient demographics, bladder condition parameters, and treatment outcomes were analyzed. Logistic regression and receiver operating characteristic curve analyses were performed to identify predictors of treatment success. Of the 118 patients, 71 (60.1%) showed satisfactory treatment outcomes after the injection. Post-injection status, bladder management, and injection frequency varied significantly among patients with satisfactory and unsatisfactory treatment outcomes. Age, bladder compliance, intravesical pressure, and bladder contractility were indicators of satisfactory outcomes. The first sensation of bladder filling of ≤263 mL, intravesical pressure of ≤28, and bladder contractility index of ≥14 were highly correlated with satisfactory outcomes. A urethral sphincter BoNT-A injection shows promise in managing dysuria in patients with SCI. Understanding bladder condition parameters and patient demographics helps optimize patient selection for this intervention. Further studies are needed to validate these findings and refine treatment protocols.
- Published
- 2024
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