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Rehabilitation Practice and Science

Translated Title

同時注射肉毒桿菌毒素於逼尿肌與尿道外括約肌對於脊髓損傷病患神經性膀胱功能障礙之先行療效研究

Abstract

Objective: This study examines clinical voiding records and urodynamic data to evaluate the therapeutic effects of concomitant botulinum toxin injections to the detrusor and external sphincter for the management of neurogenic bladder dysfunction in patients of spinal cord injury (SCI).Method: SCI patients with neurogenic bladder dysfunction who have both detrusor overactivity and detrusor external sphincter dyssynergia were recruited from a medical center in Central Taiwan. Six patients received concomitant injections of botulinum toxin to the detrusor and external sphincter. Their voiding records and urodynamic studies were compared between pre-treatment and one month post-treatment. Results: A total of 6 patients were recruited in the study. At one month after the injection, their bladder capacity (median: 360 ml vs. 490 ml, p＜0.05) and catheterized volume significantly increased (median: 240 ml vs. 290 ml, p＜0.05). The self-voiding volume also mildly increased but was not significantly different (median: 170 ml vs. 200 ml, p=0.068).The frequency of catheterization significantly decreased (median: 4.8 times vs. 3.3 times, p＜0.05). The urodynamic studies showed significantly decreased pressure profiles after treatment. The comparisons of these pressure profiles before and after treatment included the maximal intravesical pressure (median: 101.00 cmH_20 vs. 58.00 cmH_20, p＜0.05),maximal urethral pressure (median: 104.00 cmH20 vs. 63.50 cmH20, p＜0.05), and leak point pressure (median: 83.00 cmH_20 vs. 41.50 mH_20, p＜0.05). Conclusions: For patients with spinal cord injuries and neurogenic bladder dysfunction, the concomitant injection of botulinum toxin to the detrusor and external sphincter could increase bladder capacity and decrease intravesical pressure without increasing the frequency of catheterization. This treatment may be a good option for the selected patients.

Language

Traditional Chinese

First Page

89

Last Page

95

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