Eficácia da toxina botulínica do tipo A no tratamento de disfunção neurogénica do baixo aparelho urinário devida a traumatismo medular

Abstract

Introduction

The prevalence of neurogenic lower urinary tract disfunction (NLUTD) is unknown, but the risk of developing NLUTD associated with spinal cord injury (SCI) is high.

Objectives

Verify the changes of intradetrusor BTX‐A injection on urodynamic parameters and in the QoL of NLUTD patients due to SCI.

Material and methods

Retrospective study of 38 patients with SCI submitted to BTX‐A injection in our departments. Urodinamic studies were performed before and 3 to 6 months after treatment. QoL was evaluated by the Qualiveen questionnaire applied to 20 patients. Statistical analysis was performed with correlation tests for paired samples.

Results

Mean age was 38 years (Min = 23; Máx = 63), with 63.2% of males. The most frequent level of SCI was thoracic (52.6%). The average period between the SCI and the first treatment was 92 months (15 to 240 months). The patients had a mean of 3 treatments (min = 1;máx = 8), with 3 episodes of side effects ‐ transient and mild hypoasthenia. We collected data of urodynamic studies in 35 patients that showed increase in bladder capacity (p = 0,24) and compliance (p < 0,01) as well as a reduction in Pdet_max (p < 0.01). 20 patients answered the Qualiveen questionnaire with a mean result of 1 (possible final score 0‐4)

Discussion/Conclusion

The use of BTX‐A in our NLUTD patients is a treatment option with very good outcomes and important improvements in urodynamic parameters and in patients quality of life.