Abstract
Objective
To evaluate the effects of transrectal ultrasound-guided trocar catheter transurethral
botulinum toxin A (BTX-A) injection into the external urethral sphincter (EUS) for
treating detrusor external sphincter dyssynergia (DESD) in men with spinal cord injury
(SCI).
Design
Descriptive study.
Setting
Hospital rehabilitation department.
Participants
Patients (N=15; mean age, 40.5y; range, 22–64y) with suprasacral SCI with confirmed
DESD determined by urodynamic study.
Interventions
A single dose of 100U BTX-A was injected into the EUS via transrectal ultrasound-guided
trocar catheter transurethral injection.
Main Outcome Measures
Maximal detrusor pressure, detrusor leak point pressure, maximal pressure on static
urethral pressure profilometry, postvoid residual volume, and maximal flow rate.
Results
After BTX-A transurethral injection, 4 (28.5%) patients showed an excellent result
and 7 (46.7%) patients showed an improved result, whereas 4 (28.5%) patients experienced
treatment failure. The overall success rate was 75.2%. We observed a significant decrease
in static urethral pressure (P<.05) and detrusor leak point pressure after treatment (P<.05), but not in detrusor pressure. The postvoid residual volume were significantly
decreased in the fourth week after treatment (P<.05).
Conclusions
Transrectal ultrasound-guided trocar catheter transurethral BTX-A injection into the
EUS effectively suppresses or ameliorates DESD. A potential advantage of the method
is that ultrasound guidance may not be necessary in the next injection.
Keywords
List of abbreviations:
BTX-A (botulinum toxin A), CIC (clean intermittent catheterization), DESD (detrusor external sphincter dyssynergia), EUS (external urethral sphincter), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 24, 2014
Footnotes
Supported by the Cyrus Tang Foundation (grant no. GK-K-0005-100123).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
