Abstract：Detrusor external sphincter dyssynergia (DESD) is common urodynamic findings in patients with suprasacral spinal cord injury, and multiple sclerosis. Patients' quality of life is impacted severely if the condition is not treated appropriately. As a common neurotoxin, botulinum toxin works through inhibiting vesicular neurotransmitter release at the neuromuscular and neuroglandular junctions. External sphincter injections of botulinum toxin were of short-term efficacy by relaxing external sphincter passively. However, efficacy may be affected by pathophysiology of disease states, or the sex distribution of patients. In this study we review the mechanism, safety, efficacy and side effects of botulinum toxin in treating detrusor external sphincter dyssynergia.
尚振华, 颜灏, 贾春松, 崔波, 高伟, 王旭, 王巨昆, 王琦, 崔昕, 欧彤文. 肉毒毒素治疗逼尿肌-外括约肌协同失调[J]. 微创泌尿外科杂志, 2017, 6(5): 315-320.
Shang Zhenhua, Yan Hao, Jia Chunsong, Cui Bo, Gao Wei, Wang Xu, Wang Jukun, Wang Qi, Cui Xin, Ou Tongwen. Use of botulinum toxin in the treatment of detrusor external sphincter dyssynergia. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(5): 315-320.
[1] Barbalat Y, Rutman M. Detrusor-external sphincter dyssynergia: review of minimally invasive and endoscopic management. Urology, 2016,90:3-7. [2] Huang M, Chen H, Jiang C, et al. Effects of botulinum toxin A injections in spinal cord injury patients with detrusor overactivity and detrusor sphincter dyssynergia. J Rehabil Med, 2016,48(8):683-687. [3] Yang WX, Zhu HJ, Chen WG, et al. Treatment of detrusor external sphincter dyssynergia using ultrasound-guided trocar catheter transurethral botulinum toxin A injection in men with spinal cord injury. Arch Phys Med Rehabil, 2015,96(4):614-619. [4] Smith CP, Chancellor MB. Botulinum toxin to treat neurogenic bladder. Semin Neurol, 2016,36(1):5-9. [5] Matillon X, Terrier JE, Arnouil N, et al. [Temporary urethral stents ALLIUM BUS "BULBAR URETHRAL STENT" for the treatment of detrusor sphincter dyssynergia] (French). Prog Urol, 2016,26(9):532-537. [6] Mauruc E, Guinet-Lacoste A, Falcou L, et al. Nocturnal urinary disorders and multiple sclerosis: clinical and urodynamic study of 309 patients. J Urol, 2017,197(2):432-437. [7] Stoffel JT. Detrusor sphincter dyssynergia: a review of physiology, diagnosis, and treatment strategies. Transl Androl Urol, 2016,5(1):127-135. [8] Gliga LA, Lavelle RS, Christie AL, et al. Urodynamics findings in transverse myelitis patients with lower urinary tract symptoms: Results from a tertiary referral urodynamic center. Neurourol Urodyn, 2017,36(2):360-363. [9] Ogawa T, Sakakibara R, Kuno S, et al. Prevalence and treatment of LUTS in patients with Parkinson disease or multiple system atrophy. Nat Rev Urol, 2017,14(2):79-89. [10] Gammie A, Bosch R, Djurhuus JC, et al. Do we need better methods of assessing urethral function: ICI-RS 2013? Neurourol Urodyn, 2014, 33(5):587-590. [11] Blaivas JG, Sinha HP, Zayed AA, et al. Detrusor-external sphincter dyssynergia: a detailed electromyographic study. J Urol, 1981,125(4):545-548. [12] Yalla SV, Blunt KJ, Fam BA, et al. Detrusor-urethral sphincter dyssynergia. J Urol, 1977, 118(6):1026-1029. [13] Weld KJ, Graney MJ, Dmochowski RR. Clinical significance of detrusor sphincter dyssynergia type in patients with post-traumatic spinal cord injury. Urology, 2000,56(4):565-568. [14] Pirazzini M, Rossetto O, Eleopra R, et al. Botulinum neurotoxins: biology, pharmacology, and toxicology. Pharmacol Rev, 2017,69(2):200-235. [15] Jiang YH, Liao CH, Kuo HC. Current and potential urological applications of botulinum toxin A. Nat Rev Urol, 2015,12(9):519-533. [16] Smith TJ, Hill KK, Raphael BH. Historical and current perspectives on Clostridium botulinum diversity. Res Microbiol, 2015,166(4):290-302. [17] Montecucco C, Rasotto MB. On botulinum neurotoxin variability. MBio, 2015,6(1):e02131-14. [18] Dykstra DD, Sidi AA, Scott AB, et al. Effects of botulinum A toxin on detrusor-sphincter dyssynergia in spinal cord injury patients. J Urol, 1988,139(5):919-922. [19] Jhang JF, Kuo HC. Botulinum toxin A and lower urinary tract dysfunction: pathophysiology and mechanisms of action. Toxins (Basel), 2016,8(4):120. [20] Tyagi P, Kashyap M, Yoshimura N, et al. Past, present and future of chemodenervation with botulinum toxin in the treatment of overactive bladder. J Urol, 2017,197(4):982-990. [21] Coelho A, Dinis P, Pinto R, et al. Distribution of the high-affinity binding site and intracellular target of botulinum toxin type A in the human bladder. Eur Urol, 2010,57(5):884-890. [22] Coelho A, Cruz F, Cruz CD, et al. Spread of onabotulinumtoxinA after bladder injection. Experimental study using the distribution of cleaved SNAP-25 as the marker of the toxin action. Eur Urol, 2012,61(6):1178-1184. [23] Moore DC, Cohn JA, Dmochowski RR. Use of botulinum toxin A in the treatment of lower urinary tract disorders: a review of the literature. Toxins (Basel), 2016,8(4):88. [24] Hanna-Mitchell AT, Wolf-Johnston AS, Barrick SR, et al. Effect of botulinum toxin A on urothelial-release of ATP and expression of SNARE targets within the urothelium. Neurourol Urodyn, 2015,34(1):79-84. [25] Marcelissen TA, Rahnama'i MS, Snijkers A, et al. Long-term follow-up of intravesical botulinum toxin-A injections in women with idiopathic overactive bladder symptoms. World J Urol, 2017,35(2):307-311. [26] Gallien P, Robineau S, Verin M, et al. Treatment of detrusor sphincter dyssynergia by transperineal injection of botulinum toxin. Arch Phys Med Rehabil, 1998,79(6):715-717. [27] Eldred-Evans D, Dasgupta P. Use of botulinum toxin for voiding dysfunction. Transl Androl Urol, 2017,6(2):234-251. [28] Chen SL, Bih LI, Chen GD, et al. Transrectal ultrasound-guided transperineal botulinum toxin A injection to the external urethral sphincter for treatment of detrusor external sphincter dyssynergia in patients with spinal cord injury. Arch Phys Med Rehabil, 2010,91(3):340-344. [29] Tsai SJ, Ying TH, Huang YH, et al. Transperineal injection of botulinum toxin A for treatment of detrusor sphincter dyssynergia: localization with combined fluoroscopic and electromyographic guidance. Arch Phys Med Rehabil, 2009,90(5):832-836. [30] Kuo HC. Satisfaction with urethral injection of botulinum toxin A for detrusor sphincter dyssynergia in patients with spinal cord lesion. Neurourol Urodyn, 2008,27(8):793-796. [31] Mahfouz W, Karsenty G, Corcos J. Injection of botulinum toxin type A in the urethral sphincter to treat lower urinary tract dysfunction: review of indications, techniques and results: 2011 update. Can J Urol, 2011,18(4):5787-5795. [32] Chen SL, Bih LI, Chen GD, et al. Comparing a transrectal ultrasound-guided with a cystoscopy-guided botulinum toxin A injection in treating detrusor external sphincter dyssynergia in spinal cord injury. Am J Phys Med Rehabil, 2011,90(9):723-730. [33] Utomo E, Groen J, Blok BF. Surgical management of functional bladder outlet obstruction in adults with neurogenic bladder dysfunction. Cochrane Database Syst Rev, 2014,(5):CD004927. [34] Kuo YC, Kuo HC. Botulinum toxin injection for lower urinary tract dysfunction. Int J Urol, 2013,20(1):40-55. [35] Wheeler JS, Walter JS, Chintam RS, et al. Botulinum toxin injections for voiding dysfunction following SCI. J Spinal Cord Med, 1998,21(3):227-229. [36] Schurch B, Hodler J, Rodic B. Botulinum A toxin as a treatment of detrusor-sphincter dyssynergia in patients with spinal cord injury: MRI controlled transperineal injections. J Neurol Neurosurg Psychiatry, 1997,63(4):474-476. [37] Liao YM, Kuo HC. Causes of failed urethral botulinum toxin A treatment for emptying failure. Urology, 2007,70(4):763-766. [38] Schurch B, Stöhrer M, Kramer G, et al. Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? preliminary results. J Urol, 2000,164(3 Pt 1):692-697. [39] Petit H, Wiart L, Gaujard E, et al. Botulinum A toxin treatment for detrusor-sphincter dyssynergia in spinal cord disease. Spinal Cord, 1998,36(2):91-94. [40] Dykstra DD, Sidi AA. Treatment of detrusor-sphincter dyssynergia with botulinum A toxin: a double-blind study. Arch Phys Med Rehabil, 1990,71(1):24-26. [41] De Sèze M, Petit H, Gallien P, et al. Botulinum a toxin and detrusor sphincter dyssynergia: a double-blind lidocaine-controlled study in 13 patients with spinal cord disease. Eur Urol, 2002,42(1):56-62. [42] Gallien P, Reymann JM, Amarenco G, et al. Placebo controlled, randomised, double blind study of the effects of botulinum A toxin on detrusor sphincter dyssynergia in multiple sclerosis patients. J Neurol Neurosurg Psychiatry, 2005,76(12):1670-1676. [43] 廖利民,付光,史文博,等.尿道括约肌内注射A型肉毒毒素治疗脊髓损伤患者逼尿肌-括约肌协同失调的临床观察.中国脊柱脊髓杂志,2006,16(6):409-412. [44] Mehta S, Hill D, Foley N, et al. A meta-analysis of botulinum toxin sphincteric injections in the treatment of incomplete voiding after spinal cord injury. Arch Phys Med Rehabil, 2012,93(4):597-603. [45] Groen J, Pannek J, Castro Diaz D, et al. Summary of European association of urology (EAU) guidelines on Neuro-Urology. Eur Urol, 2016,69(2):324-333. [46] Nuanthaisong U, Abraham N, Goldman HB. Incidence of adverse events after high doses of onabotulinumtoxinA for multiple indications. Urology, 2014,84(5):1044-1048.
