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Botulinum Toxin Injections in the Bladder and Urethral Sphincter

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Handbook of Neurourology

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Abstract

Detrusor injections of botulinum toxin A (BTX-A), one of the seven subtypes of the neurotoxin produced by the Clostridium botulinum, changed the management of neurogenic detrusor overactivity (NDO). BTX-A is available in different commercial forms, with the non-proprietary names of onabotulinum toxin A (onabotA), abobotulinum toxin A (abobotA), and incobotulinum toxin A (incobotA) for the registered names of Botox®, Dysport®, and Xeomin®, respectively. Prosigne does not have a non-proprietary name. Among the other serotypes, only the subtype B was investigated in NDO, with disappointing results so far.

Most of the information concerning the use of BTX-A in adults and children with NDO comes from large randomized and observational clinical trials that used onabotA or abobotA. Most of the adult NDO patients included in such trials suffered from spinal cord injury and multiple sclerosis, while most of the NDO children had myelomeningocele.

Efficacy of BTX-A in controlling NDO incontinence and reducing maximal detrusor pressure and involuntary detrusor contractions is high. The effect of one treatment may last between 6 and 12 months. Adverse effects associated with bladder injection of the toxin are mild urinary tract infections and increase in post-void residual urine and are mostly observed in patients with spontaneous micturition.

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Authors and Affiliations

  1. Department of Urology, Hospital de S. João, Porto, Portugal

    João Silva & Francisco Cruz

  2. Faculty of Medicine of the University of Porto, Porto, Portugal

    João Silva & Francisco Cruz

  3. Instituto de Investigação e Inovação em Saúde (i3S), Porto, Portugal

    João Silva & Francisco Cruz

Authors
  1. João Silva
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  2. Francisco Cruz
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Correspondence to Francisco Cruz .

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Editors and Affiliations

  1. Department of Urology Department of Neurourology, China Rehabiliation Research Center China Rehabilitation Science InstituteCapital Medical University, Beijing, China

    Limin Liao

  2. Department of Urology, Medical University Innsbruck, University Hospital, Innsbruck, Austria

    Helmut Madersbacher

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Silva, J., Cruz, F. (2023). Botulinum Toxin Injections in the Bladder and Urethral Sphincter. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_33

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  • DOI: https://doi.org/10.1007/978-981-99-1659-7_33

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-1658-0

  • Online ISBN: 978-981-99-1659-7

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