Botulinum A toxin and detrusor sphincter dyssynergia: Retrospective study of 47 patients [Toxine botulique A et dyssynergie vésico-sphinctérienne: étude rétrospective portant sur 47 patients]

摘要

Introduction: To assess the efficacy of injections of botulinum toxin type A (BT-A) in the urethral sphincter for treating detrusor sphincter dyssynergia (DSD). Patients and methods: Retrospective observational study of patients with confirmed urodynamic DSD (neurological and non-neurological etiologies) treated at our center from 2002 to 2010. All patients received 300 IU of DYSPORT? injected transperineally under electromyographic control. Using a visual analog scale (VAS) for mictional disorders and the measure of the post-void residual (PVR) as criteria of efficacy, results were classified as "non-satisfactory" (decrease in the VAS2 or decrease in the PVR20%), "intermediate" (decrease in the VAS≥2 or decrease in the PVR≥20%) or "satisfactory" (decrease in the VAS3 or decrease in the PVR40%). Results: Records of 47 patients (7 women and 40 men) were studied. Mean follow-up was 14.2 months. At the end of follow-up, there were 23.4% (11) of "satisfactory" results, 19.1% (9) of "intermediate" results, 42.6% (20) of "non-satisfactory" results and 14.9% (7) of patients lost for follow-up. The mean decrease in PVR was 60. mL (from an average of 212 to an average of 152. mL). No side effect was observed. Conclusion: In this small series reporting the results of the injection of BT-A in the urethral sphincter for DSD, we observed 42.5% of satisfactory or intermediate results without associated side effects.