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Ancillary benefits of bladder chemodenervation for SCI neurogenic bladder
Brandon M Haynes1, Nathan C Osbun1, Claire C Yang1
1Department of Urology, University of Washington, Seattle, WA USA.
Spinal Cord Series and Cases
|September 25, 2018
Summary
Bladder chemodenervation in spinal cord injury (SCI) patients effectively treats neurogenic detrusor overactivity (NDO) and may improve autonomic dysreflexia (AD) and spasticity. This study found ancillary benefits beyond lower urinary symptom relief.
Area of Science:
- Neuroscience
- Urology
- Rehabilitation Medicine
Background:
- Neurogenic bladder, often due to spinal cord injury (SCI), causes neurogenic detrusor overactivity (NDO).
- Anecdotal evidence suggests bladder chemodenervation may also alleviate non-bladder symptoms like autonomic dysreflexia (AD) and muscle spasticity.
Purpose of the Study:
- To investigate the efficacy of bladder chemodenervation in improving non-bladder symptoms, specifically AD and muscle spasticity, in patients with SCI.
- To assess ancillary benefits of onabotulinumtoxinA treatment for NDO.
Main Methods:
- A case series of 21 SCI patients undergoing bladder chemodenervation with onabotulinumtoxinA (200 units) for refractory NDO.
- Patients completed questionnaires on non-NDO symptoms (AD, spasticity) before and 6-12 weeks after the procedure.
Main Results:
- All patients experienced NDO symptom improvement.
- 10/10 patients with prior AD symptoms reported improvement.
- 12/21 patients reported improvement in non-bladder symptomatology, including reduced spasticity.
Conclusions:
- Bladder chemodenervation offers significant ancillary benefits for SCI patients beyond treating NDO.
- Potential mechanisms include dampening noxious reflex responses initiated by the bladder.
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