Effect of botulinum a toxin in the treatment of XXXX due to detrusor underactivity.

@entity1 @entity409 @entity1897 @entity2507 @entity3833 @entity1971
OBJECTIVES: To investigate the effects of botulinum A toxin in treating @entity1 with @entity409 due to detrusor underactivity. METHODS: Twenty @entity1 with chronic urinary retention (n = 13) or severe @entity3833 (n = 7) received 50 U of botulinum A toxin by urethral injection. The clinical effects, obstructive symptom score, quality-of-life index, and urodynamics were compared at baseline and after treatment. RESULTS: Of the 4 males and 16 females (age range 14 to 86 years) with @entity409 ( @entity1971 in 5, @entity409 in 5, @entity1897 in 6, and detrusor failure of unknown origin in 4), 18 (90%) were treated satisfactorily. Among these @entity1 , the mean quality-of-life score decreased significantly from 5.68 +/- 0.67 to 1.16 +/- 1.61. The median voiding pressure (56.5 +/- 41.2 versus 39.0 +/- 38.4 cm @entity2507 ) decreased significantly, as did the maximal urethral closure pressure (65.5 +/- 38.1 versus 50 +/- 32.1 cm @entity2507 ) and residual urine volume (300 +/- 189.1 versus 50 +/- 153.6 mL) at 2 weeks after treatment and remained stationary for 3 months. The subjective maximal effect was achieved within 1 to 2 weeks. In 7 @entity1 , the indwelling catheters were removed, and in 4 @entity1 who performed clean intermittent self-catheterization, the frequency decreased or it was discontinued. The other 7 @entity1 with difficult urination had significant improvement in the obstructive symptom score (18 +/- 3.3 versus 7 +/- 4.5, P = 0.000). CONCLUSIONS: Botulinum A toxin at a dose of 50 U was effective in reducing urethral sphincter resistance among our @entity1 with detrusor underactivity and difficult urination.
