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Botulinum toxin injections for voiding dysfunction following SCI

J S Wheeler1, J S Walter, R S Chintam

  • 1Rehabilitation Research and Development Center, Edward Hines, Jr., Veterans Affairs Hospital, Hines, IL, USA.

The Journal of Spinal Cord Medicine
|December 24, 1998
PubMed
Summary
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Botulinum toxin (BT) injections effectively treat voiding dysfunction in spinal cord injury (SCI) patients. This minimally invasive treatment offers significant benefits for managing bladder issues, particularly for those unsuitable for surgery.

Area of Science:

  • Urology
  • Neurology
  • Rehabilitation Medicine

Background:

  • Spastic muscle conditions, such as detrusor-sphincter dyssynergia (DSD), are common in spinal cord injury (SCI) patients.
  • Voiding dysfunction significantly impacts the quality of life for individuals with SCI.

Observation:

  • Three SCI patients with voiding dysfunction were treated with botulinum toxin (BT) injections using transperineal needle and electromyographic (EMG) monitoring.
  • Two patients experienced excellent outcomes, with one showing improved intermittent catheterization (IC) and another with improved voiding and reduced urinary residual.

Findings:

  • Botulinum toxin (BT) injections demonstrated significant efficacy in managing voiding dysfunction in two out of three SCI patients.
  • One patient required a sphincterotomy due to persistent leg spasms and voiding dysfunction, indicating varied responses to BT treatment.

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Implications:

  • BT injections represent a minimally invasive and safe therapeutic option for SCI patients with voiding dysfunction, especially those who are not candidates for surgery.
  • This treatment is particularly beneficial for patients relying on external catheters or intermittent catheterization (IC) who have contraindications for surgical interventions.