Botulinum toxin therapy for neurogenic detrusor overactivity.
Publication/Presentation Date
11-1-2010
Abstract
Detrusor injection of botulinum toxin (BTX) has shown great promise in the treatment of neurogenic detrusor overactivity (NDO) refractory to conservative therapy. Despite a paucity of prospective evidence, there exists a growing consensus that BTX injection therapy is a well-tolerated, low-risk therapy. Injections result in substantial subjective improvement in continence and quality of life. Moreover, assessment of urodynamic parameters demonstrates objective changes: (1) an increase in maximum cystometric capacity; (2) when applicable, a reduction in maximal detrusor voiding pressures; and (3) an increase in bladder compliance in cases where baseline bladder compliance measures were abnormal. While BTX bladder injection offers both objective and subjective measures of incontinence control, treatment duration is limited by the gradual reinnervation of injected tissue over an approximately 6- to 9-month interval. However, repeat injection cycles do appear to achieve similar levels of efficacy. The objective of this review is to provide a focused summary of the current body of literature, investigating the safety and efficacy of bladder BTX injection in patients with NDO.
Volume
37
Issue
4
First Page
567
Last Page
580
ISSN
1558-318X
Published In/Presented At
Smaldone, M. C., Ristau, B. T., & Leng, W. W. (2010). Botulinum toxin therapy for neurogenic detrusor overactivity. The Urologic clinics of North America, 37(4), 567–580. https://doi.org/10.1016/j.ucl.2010.06.001
Disciplines
Medicine and Health Sciences
PubMedID
20955908
Department(s)
Department of Surgery
Document Type
Article