Treating Neurogenic Lower Urinary Tract Dysfunction in Chronic Spinal Cord Injury Patients-When Intravesical Botox Injection or Urethral Botox Injection Are Indicated

Po-Cheng Chen; Kau-Han Lee; Wei-Chia Lee; Ting-Chun Yeh; Yuh-Chen Kuo; Bing-Juin Chiang; Chun-Hou Liao; En Meng; Yao-Lin Kao; Yung-Chin Lee; Hann-Chorng Kuo

doi:10.3390/toxins15040288

Treating Neurogenic Lower Urinary Tract Dysfunction in Chronic Spinal Cord Injury Patients-When Intravesical Botox Injection or Urethral Botox Injection Are Indicated

Toxins (Basel). 2023 Apr 17;15(4):288. doi: 10.3390/toxins15040288.

Authors

Po-Cheng Chen¹, Kau-Han Lee², Wei-Chia Lee³, Ting-Chun Yeh⁴, Yuh-Chen Kuo^{5

6}, Bing-Juin Chiang^{7

8}, Chun-Hou Liao^{9

10}, En Meng¹¹, Yao-Lin Kao¹², Yung-Chin Lee¹³, Hann-Chorng Kuo¹⁴

Affiliations

¹ Urologic Department, En Chu Kong Hospital, New Taipei City 237414, Taiwan.
² Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan.
³ Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
⁴ Division of Urology, Department of Surgery, Taiwan Adventist Hospital, Taipei City 10556, Taiwan.
⁵ Department of Urology, Yangming Branch of Taipei City Hospital, Taipei 11146, Taiwan.
⁶ Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan.
⁷ College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan.
⁸ Department of Urology, Cardinal Tien Hospital, New Taipei City 23148, Taiwan.
⁹ Divisions of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 23148, Taiwan.
¹⁰ School of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
¹¹ Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
¹² Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
¹³ Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, Taiwan.
¹⁴ Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97004, Taiwan.

Abstract

Lower urinary tract symptoms (LUTS), such as urgency, urinary incontinence, and/or difficulty voiding, hamper the quality of life (QoL) of patients with spinal cord injury (SCI). If not managed adequately, urological complications, such as urinary tract infection or renal function deterioration, may further deteriorate the patient's QoL. Botulinum toxin A (BoNT-A) injection within the detrusor muscle or urethral sphincter yields satisfactory therapeutic effects for treating urinary incontinence or facilitating efficient voiding; however, adverse effects inevitably follow its therapeutic efficacy. It is important to weigh the merits and demerits of BoNT-A injection for LUTS and provide an optimal management strategy for SCI patients. This paper summarizes different aspects of the application of BoNT-A injection for lower urinary tract dysfunctions in SCI patients and provides an overview of the benefits and drawbacks of this treatment.

Keywords: botulinum toxins; lower urinary tract symptoms; spinal cord injury.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Botulinum Toxins, Type A* / adverse effects
Humans
Neuromuscular Agents* / therapeutic use
Quality of Life
Spinal Cord Injuries* / complications
Spinal Cord Injuries* / drug therapy
Treatment Outcome
Urinary Bladder
Urinary Bladder, Neurogenic* / drug therapy
Urinary Bladder, Neurogenic* / etiology
Urinary Incontinence* / drug therapy
Urinary Incontinence* / etiology

Substances

Botulinum Toxins, Type A
Neuromuscular Agents

Grants and funding

This research was funded by the Buddhist Tzu Chi Medical Foundation grants TCMF-SP-108-01 and TCMF-MP-110-03-01.