Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2008
[Kidney transplantation and lower tract obstructive uropathy treated by Botox: a case report].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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El Fellah H, Zakaria Y, Fassi Fehri H, Badet L, Martin X
Аннотация
INTRODUCTION: The indications for botulinum toxin have been extended in the field of urology, especially in vesicosphincteric dysfunction with good results. The authors report the use of botulinum toxin in a kidney transplant recipient with urethral hypertonia partly responsible for end-stage chronic kidney disease.
CASE REPORT: Mr E.J, 25 years old, was operated for bilateral megaureter with vesicosphincteric dysfunction during childhood. He was managed in our department with serum creatinine of 364 mol/l. Ultrasound showed bilateral ureteropelvic dilatation and residual urine of 300 ml. Urodynamic assessment demonstrated a normally active bladder with normal compliance and urethral hypertonia. An intrasphincter injection of 300 units of Botox was performed in May 2003 with a good result for 11 months. He subsequently received a second intrasphincter injection of 200 units with clinical efficacy maintained for at least six months. This patient underwent living-donor kidney transplantation in May 2005. An intrasphincter injection of 100 units of Botox was performed nine days after transplantation, then every six months. With a follow-up of 16 months, renal function is stable with negligible residual urine.
DISCUSSION: The use of botulinum toxin in non neurogenic urethral hypertonia has been reported in only a few original articles. Botulinum toxin injection into the striated sphincter of the urethra decreases urethral resistance, improving obstructive symptoms and can be effective in kidney transplant recipients.
CASE REPORT: Mr E.J, 25 years old, was operated for bilateral megaureter with vesicosphincteric dysfunction during childhood. He was managed in our department with serum creatinine of 364 mol/l. Ultrasound showed bilateral ureteropelvic dilatation and residual urine of 300 ml. Urodynamic assessment demonstrated a normally active bladder with normal compliance and urethral hypertonia. An intrasphincter injection of 300 units of Botox was performed in May 2003 with a good result for 11 months. He subsequently received a second intrasphincter injection of 200 units with clinical efficacy maintained for at least six months. This patient underwent living-donor kidney transplantation in May 2005. An intrasphincter injection of 100 units of Botox was performed nine days after transplantation, then every six months. With a follow-up of 16 months, renal function is stable with negligible residual urine.
DISCUSSION: The use of botulinum toxin in non neurogenic urethral hypertonia has been reported in only a few original articles. Botulinum toxin injection into the striated sphincter of the urethra decreases urethral resistance, improving obstructive symptoms and can be effective in kidney transplant recipients.