The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA

Urology Annals, 2015 · DOI: 10.4103/0974-7796.152013 · Published: July 1, 2015

Simple Explanation

This study investigates the effectiveness and safety of OnabotulinumtoxinA (Botox) injections for treating neurogenic detrusor overactivity (NDO) in patients with spinal cord injuries (SCI). NDO is a condition characterized by involuntary bladder contractions that can lead to urinary frequency, urgency, and incontinence. The researchers aimed to determine if the level of spinal cord injury (cervical, thoracic, or lumbar) influenced the outcome of Botox treatment. They reviewed data from 103 patients who received Botox injections for lower urinary tract symptoms related to NDO. The study found that Botox injections improved bladder function and reduced incontinence episodes in SCI patients with NDO. Patients with thoracic and lumbar injuries experienced better outcomes compared to those with cervical injuries.

Study Duration

January 2007 and December 2013

Participants

103 patients with neurogenic bladder secondary to SCI

Evidence Level

Not specified

Key Findings

1
Urodynamic parameters such as maximum cystometric bladder capacity and reflex volume improved significantly after Botox treatment compared to baseline values.
2
There were significant reductions in the frequencies of incontinence episodes after treatment as seen in the voiding diary.
3
Patients with thoracic and lumbar injuries had better outcomes compared to cervical injury patients in terms of urodynamic parameters.

Research Summary

The study evaluated the effectiveness and safety of OnabotulinumtoxinA injections for treating neurogenic detrusor overactivity in patients with spinal cord injuries. Botox injections led to significant improvements in urodynamic parameters, reduced incontinence episodes, and increased patient satisfaction. Patients with thoracic and lumbar spinal cord injuries experienced more favorable outcomes compared to those with cervical injuries.

Practical Implications

Treatment of NDO

Intradetrusor OnabotulinumtoxinA injections are an effective and well-tolerated treatment for neurogenic overactive bladder.

Improved QOL

The treatment increases patient satisfaction and improve QOL with persisted clinical efficacy for more than 8 months.

SCI Level Consideration

The effect might be less favorable in cervical SCI patients when compared to thoracic and lumbar SCI patients.

Study Limitations

1
The present study limitation related to the use of concurrent antimuscarinics in some patients.
2
Small sample size of patients with cervical spinal cord injuries.
3
Not specified

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury