Urethral Sphincter Botulinum Toxin A Injection for Non-Spinal Cord Injured Patients with Voiding Dysfunction without Anatomical Obstructions: Which Patients Beneﬁt Most?

Toxins, 2023 · DOI: 10.3390/toxins15020087 · Published: January 17, 2023

Simple Explanation

This study investigates the use of urethral botulinum toxin A (BoNT-A) injections to treat voiding dysfunction in patients without spinal cord injuries or anatomical obstructions. The study compares the effectiveness of BoNT-A injections in patients with detrusor underactivity (DU), dysfunctional voiding (DV), and poor relaxation of the external sphincter (PRES). The results showed that patients with DV had the highest success rate, while DU and PRES patients also experienced some benefit.

Study Duration

Not specified

Participants

161 patients with refractory voiding dysfunction

Evidence Level

Level 3, Retrospective Analysis

Key Findings

1
DV patients had a higher success rate (76.6%) than DU (50%) and PRES (45.8%) patients (p = 0.002) after urethral BoNT-A injection.
2
A diagnosis of DV, higher voided volume and recurrent urinary tract infection were predictors of a good treatment response.
3
PVR > 250 mL was identified as a negative predictor (p = 0.008) in DU patients.

Research Summary

The study found that urethral BoNT-A injections can be effective for treating non-SCI voiding dysfunction, especially in patients with dysfunctional voiding (DV). Patients with detrusor underactivity (DU) and poor relaxation of the external sphincter (PRES) also experienced some benefit, although to a lesser extent than those with DV. A post-void residual volume greater than 250 mL was identified as a negative predictor of treatment success in DU patients.

Practical Implications

Treatment Selection

Urethral BoNT-A injections are a viable treatment option for non-SCI patients with voiding dysfunction, particularly those with DV.

Patient Stratification

VUDS should be used to accurately diagnose the type of voiding dysfunction (DU, DV, PRES) to optimize treatment outcomes.

Prognostic Factors

PVR should be monitored in DU patients to predict the likelihood of success with BoNT-A injections.

Urethral Sphincter Botulinum Toxin A Injection for Non-Spinal Cord Injured Patients with Voiding Dysfunction without Anatomical Obstructions: Which Patients Beneﬁt Most?

Simple Explanation

Key Findings

Research Summary

Practical Implications

Treatment Selection

Patient Stratification

Prognostic Factors

Study Limitations

Your Feedback

Was this summary helpful?

Urethral Sphincter Botulinum Toxin A Injection for Non-Spinal Cord Injured Patients with Voiding Dysfunction without Anatomical Obstructions: Which Patients Beneﬁt Most?

Simple Explanation

Key Findings

Research Summary

Practical Implications

Treatment Selection

Patient Stratification

Prognostic Factors

Study Limitations

Your Feedback

Was this summary helpful?