| Causes of failed urethral botulinum toxin A treatment for emptying failure. | |
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MedLine Citation:
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PMID: 17707894 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Urethral injection of botulinum toxin A (BTX-A) can reduce urethral resistance in patients with voiding dysfunction. However, some patients do not benefit from this treatment. It is essential to identify the causes for these failed procedures. METHODS: A total of 200 patients receiving urethral BTX-A injections for voiding dysfunction refractory to conventional medication during a 5-year period were included in this study. The patients received 50 or 100 U of BTX-A injected into the urethral sphincter. Treatment was considered successful when patients were subjectively satisfied with the outcome and (a) patients with chronic urinary retention resumed spontaneous voiding, (b) patients with a large postvoid residual volume had a reduction in postvoid residual of more than 50%, (c) patients voided with a lower detrusor pressure or lower abdominal pressure to urinate adequately. The therapeutic results and causes of failed treatment were retrospectively analyzed. RESULTS: The overall success rate was 88.5% (177 patients), including 47.5% (95 patients) with an excellent result and 41% (82 patients) with an improved result. The causes of failed treatment in 23 patients were detrusor underactivity with very low abdominal straining pressure in 7, a tight urethral sphincter in 7, bladder neck obstruction in 7, and psychological inhibition of voiding in 2. Transurethral incision of the bladder neck was performed in 7 patients, and all had an improved result. CONCLUSIONS: BTX-A urethral treatment failed in 11.5% of patients with voiding dysfunction refractory to medical treatment after one session. Careful investigation of the underlying causes of failed treatment is mandatory to achieve a satisfactory outcome. |
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Authors:
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Yung-Ming Liao; Hann-Chorng Kuo |
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Publication Detail:
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Type: Journal Article Date: 2007-08-20 |
Journal Detail:
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Title: Urology Volume: 70 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-11-09 Completed Date: 2007-12-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 763-6 Citation Subset: IM |
Affiliation:
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Department of Urology, Buddhist Tzu Chi General Hospital and Buddhist Tzu Chi University, Hualien, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Botulinum Toxin Type A / administration & dosage* Child Female Humans Injections, Intramuscular Male Middle Aged Treatment Failure Urethra* Urinary Retention / etiology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Botulinum Toxin Type A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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