Objective: To evaluate the effects of a single transrectal ultrasound (TRUS)-guided transperineal injection of botulinum toxin A (BTX-A) to the external urethral sphincter (EUS) for treating detrusor external sphincter dyssynergia (DESD).
Design: Descriptive study.
Setting: Rehabilitation hospital affiliated with a medical university.
Participants: Patients (N=18) with suprasacral spinal cord injury who had DESD confirmed on video-urodynamic study.
Interventions: A single dose of 100U BTX-A was applied into the EUS via TRUS-guided transperineal route injection.
Main Outcome Measures: Maximal detrusor pressure, detrusor leak-point pressure, integrated electromyography (iEMG), maximal pressure on static urethral pressure profilometry, and postvoiding residuals.
Results: There were significant reductions in iEMG (P=.008) and static (P=.012) and dynamic urethral pressure (P=.023), but not in detrusor pressure and detrusor leak-point pressure after treatment. Postvoiding residuals also significantly decreased in the first and second month after treatment (P<.012).
Conclusions: TRUS-guided transperineal injection of BTX-A has beneficial effects in treating DESD.
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| http://dx.doi.org/10.1016/j.apmr.2009.11.006 | DOI Listing |
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