American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2019, 7(10), 250-252
DOI: 10.12691/ajmcr-7-10-7
Open AccessArticle

200 U vs 300 U Botulinum Toxin A Injections for Patients with Neurogenic Detrusor Overactivity Secondary to Spinal Cord Injury

Lin JM1, 2, Chen Hui1, , Liu QL1, Huang MP1, Li QQ1, Huang TH1 and Yang XY1

1Department of Urology in Guangdong Provincial Work Injury Rehabilitation Hospital, Guangdong, China

2Departments of Emergency, the Eighth Hospital of Guangzhou, Guangdong, China

Pub. Date: August 02, 2019

Cite this paper:
Lin JM, Chen Hui, Liu QL, Huang MP, Li QQ, Huang TH and Yang XY. 200 U vs 300 U Botulinum Toxin A Injections for Patients with Neurogenic Detrusor Overactivity Secondary to Spinal Cord Injury. American Journal of Medical Case Reports. 2019; 7(10):250-252. doi: 10.12691/ajmcr-7-10-7

Abstract

Objective: To evaluate the d the safety and efficacy of 200 U vs 300 U botulinum toxin A (BTX-A) injections for patients with neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI). Methods: we retrieved the data for the patients who receive a single dose into the detrusor of BTX-A (300 U or 200 U). The clinical outcome included maximum detrusor pressure (Pdetmax) during cystometry, voiding volume, urinary incontinence (UI) episodes between CICs per 24 hour, and complete dryness.Related adverse events were recorded. Results: From July 2015 to June 2017, 28 cases received 300 U BTX-A injections(experiment group) while 19 cases received 200U BTX-A injections(control group). There were no significant differences in baseline evaluation items (gender, age, duration of spinal cord injury, level of neurological injury, AIS scores) between the two groups. There were significant improvement in Pdetmax, UI and I-QoL from baseline in the two groups. Patients in experiment group had statistically greater improvement than those in the control group for Pdetmax (-32.09 cmH2O vs. -28.02 cmH2O, P = 0.016), mean urinary incontinence episodes (-6.18/d vs. -5.01/d, P = 0.042), complete dryness (11 vs. 2, P = 0.031), mean voiding volume (160.52 ml vs. 133.66 ml, P <0.001), and I-QoL (28.53 vs. 20.41, P <0.001). Conclusion: Preliminary results indicate that 300 U BTX-A is more effective than 200 U BTX-A for SCI patients with NDO.

Keywords:
botulinum toxin A 200U 300U neurogenic detrusor overactivity spinal cord injury

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References:

[1]  Abrams P, Cardozo L, Fall M, et al.The standardisation of terminology of lower urinary tract function: Report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21(2): 167-78.
 
[2]  Groen J, Pannek J, Castro Diaz D, et al.Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology[J]. Eur Urol, 2016, 69(3): 324-333.
 
[3]  Hagen EM, Eide GE, Rekand T, et al.Traumatic spinal cord injury and concomitant brain injury: a cohort study. Acta Neurol Scand Suppl 2010; (190): 51-7.
 
[4]  Chapple C, Patel A. Botulinum toxin: new mechanisms, new therapeutic directions? Eur Urol, 2006, 49 (4): 606-608.
 
[5]  Schurch B, Stöhrer M, Kramer G, et al. Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol, 2000, 164 ( 1): 692-697.
 
[6]  Patel AK, Patterson JM, Chapple CR. Botulinum toxin injections for neurogenic and idiopathic detrusor overactivity: a critical analysis of results. Eur Urol 2006; 50 (8): 684-710.