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Updated: Apr 27, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
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OnabotulinumtoxinA and multiple sclerosis.

B Schurch1, S Carda1

  • 1Neurourology, Service of Physical Medicine and Neurorehabilitation, CHU Vaudois, 5, avenue Pierre-Decker, 1011 Lausanne, Switzerland.

Annals of Physical and Rehabilitation Medicine
|June 24, 2014
PubMed
Summary
This summary is machine-generated.

Botulinum toxin type A injections effectively manage neurogenic detrusor overactivity in multiple sclerosis patients, improving quality of life for approximately nine months. Clean intermittent self-catheterisation is necessary due to potential urinary retention risks.

Keywords:
Botulinum toxinIncontinence urinaireMultiple sclerosisOveractiveSclérose en plaquesToxine botulique type AType AUrinary bladderUrinary incontinenceVessie hyperactive

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Area of Science:

  • Neurology
  • Urology

Background:

  • Multiple sclerosis (MS) frequently causes lower urinary tract dysfunction, primarily neurogenic detrusor overactivity (NDO) often with detrusor-sphincter dyssynergia.
  • NDO significantly impacts patients' quality of life.

Purpose of the Study:

  • To review the efficacy and safety of onabotulinumtoxinA for treating NDO in MS patients.
  • To highlight treatment considerations, including dosage, side effects, and patient management.

Main Methods:

  • Review of randomized placebo-controlled trials and clinical evidence on intradetrusorial onabotulinumtoxinA injections for NDO in MS.
  • Analysis of urodynamic parameters, clinical outcomes, quality of life, and adverse events.

Main Results:

  • OnabotulinumtoxinA is safe and effective for NDO in MS, improving urodynamic and clinical parameters.
  • Treatment provides a median duration of effect of nine months, with 200 UI being a common dose.
  • Clean intermittent self-catheterisation is required due to high risk of urinary retention, though it doesn't negatively impact quality of life.

Conclusions:

  • Intradetrusorial onabotulinumtoxinA injections are a valuable therapeutic option for NDO in MS patients.
  • Careful patient selection and management, including catheterisation and infection prophylaxis, are crucial for optimal outcomes.
  • Further research should consider optimal dosing and long-term effects.