Related Experiment Video
Updated: Nov 15, 2025
07:05
Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
23.8K
Endoscopic Botulinum Toxin Injection for Refractory Enuresis Based on Urodynamic Assessment
Gyoohwan Jung1, Young-Jae Im1, Gwan Jang1
1Department of Urology, Seoul National University Children's Hospital, Seoul, Korea.
International Neurourology Journal
|March 7, 2021
Summary
Videourodynamic studies identified specific causes of refractory enuresis. Differential endoscopic botulinum toxin injections effectively treated overactive bladder and sphincter hyperactivity in most patients for over a year.
Area of Science:
- Urology
- Pediatric Urology
- Neurourology
Background:
- Refractory nonmonosymptomatic enuresis often requires advanced diagnostic and therapeutic approaches.
- Conservative treatments frequently fail in cases of persistent enuresis.
Purpose of the Study:
- To determine the urodynamic characteristics of refractory enuresis.
- To evaluate the efficacy of differential endoscopic botulinum toxin injections based on these characteristics.
Main Methods:
- 27 patients with refractory nonmonosymptomatic enuresis underwent videourodynamic studies.
- Differential endoscopic botulinum toxin injections (intravesical or intrasphincteric) were administered based on urodynamic findings.
- Follow-up assessments were conducted at 1, 3, 6, and 12 months.
Main Results:
- Urodynamic diagnoses differed from initial clinical diagnoses in over half of patients.
- Intravesical injections were effective for detrusor overactivity; combined injections for sphincter hyperactivity.
- Over 80% of patients maintained treatment benefits at 1 year, with efficacy persisting for 6 months.
Conclusions:
- Videourodynamic studies are crucial for diagnosing refractory nonmonosymptomatic enuresis.
- These studies guide precise botulinum toxin injection site selection for optimal outcomes.
Related Concept Videos
01:26The Micturition Reflex
1.6K
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
1.6K
01:19Urodynamic Studies: Uroflowmetry
1.5K
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
1.5K
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
961
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
961
01:31Skeletal Muscle Relaxants: Therapeutic Uses
730
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
730
01:23Urinary Bladder
2.2K
The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
2.2K