What is the role of botulinum A toxin injection in the treatment of neurogenic bladder?

Updated: Dec 06, 2018
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

The US Food and Drug Administration (FDA) has approved botulinum toxin A for neurogenic detrusor overactivity in adults who have an inadequate response to or are intolerant of an anticholinergic drug. However, a Cochrane review that included four randomized controlled trials of botulinum A toxin injection as a treatment for detrusor-sphincter dyssynergia (DSD) found that intraurethral injections might improve some urodynamic measures after 30 days, but the studies had a high risk of bias, the quality of the evidence was limited, and the need for reinjection is a significant drawback. The authors advised that more study of effectiveness needed; optimal dose and mode of injection remain to be determined, and sphincterotomy might be a more effective option for long-term treatment. [12]


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