Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2018
[Efficacy of botulinum toxin A injections in the urethral sphincter in patients with difficulties to perform self-intermittent catherization].
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Honore T, Le Breton F, Turmel N, Bignani B, Chesnel C, Charlanes A, Amarenco G
Аннотация
PURPOSE: To evaluate safety and efficacy of botulinum toxin A injections in the urethral striated sphincter in patients with difficulties to perform self-intermittent catherization.
METHODS: In this prospective study, 12 patients suffering from upper motor neuron diseases (8 multiple sclerosis, 2 myelitis, 1 brain injury, 1 multi system atrophy) and with difficulties to perform self-intermittent catherization, defined by a ICDQ score>1 (Intermittent Catheterization Difficulty Questionnaire) have had injections of 100U BOTOX® under EMG guidance in the urethral striated sphincter, for a total of 15 injections. Evaluations consisted of two questionnaires (ICDQ and PGI-A, Patient Global Improvement) 30 days after the injection.
RESULTS: 30 days after the injection, ICDQ was improved with a mean decrease of the total score of 7.8 (SD=5.9, P<0,001). In the same manner, all the patients were improved with a mean PGI-A score of 2.3. In 73.3 % of cases, the PGI-A score was equal to 2 (improvement=much better), and in 20 % it was equal to 3 (improvement=a little better).
CONCLUSIONS: Botulinum toxin A injections in the urethral striated sphincter in patients with difficulties to perform self-intermittent catherization seem to safe and effective.
LEVEL OF EVIDENCE: 4.
METHODS: In this prospective study, 12 patients suffering from upper motor neuron diseases (8 multiple sclerosis, 2 myelitis, 1 brain injury, 1 multi system atrophy) and with difficulties to perform self-intermittent catherization, defined by a ICDQ score>1 (Intermittent Catheterization Difficulty Questionnaire) have had injections of 100U BOTOX® under EMG guidance in the urethral striated sphincter, for a total of 15 injections. Evaluations consisted of two questionnaires (ICDQ and PGI-A, Patient Global Improvement) 30 days after the injection.
RESULTS: 30 days after the injection, ICDQ was improved with a mean decrease of the total score of 7.8 (SD=5.9, P<0,001). In the same manner, all the patients were improved with a mean PGI-A score of 2.3. In 73.3 % of cases, the PGI-A score was equal to 2 (improvement=much better), and in 20 % it was equal to 3 (improvement=a little better).
CONCLUSIONS: Botulinum toxin A injections in the urethral striated sphincter in patients with difficulties to perform self-intermittent catherization seem to safe and effective.
LEVEL OF EVIDENCE: 4.