Botulinum-A-toxin for therapy of detrusor hyperreflexia in neurogenic bladders

Purpose: We evaluated the effect of transurethral injection of botulinum-A-toxin into the detrusor muscle in patients with proven detrusor hyperreflexia and previously insufficiant anticholinergic drug therapy. The purpose was to increase bladder volume and decrease incontinence. Material and method: A total of 70 patients underwent transurethral injection of botulinum-A-toxin into the detrusor muscle. We used 1000 units of Dysport((R)) in adults and 200 units of Botox((R)) in children. All patients were required to perform bladder emptying by sterile intermittent self-catheterisation. Results: In 65 of our 70 patients, continence could be achieved, bladder capacity increased significantly and maximum detrusor pressure decreased significantly. No side effects were observed. Conclusion: Transurethral injection of botulinum-A-toxin into the detrusor muscle is a safe and effective alternative in the treatment of severe detrusor hyperreflexia. The effect lasts from 6 to 9 months.