There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa .
CONCLUSION BoNT-A is effective and safe in treating NDO after SCI .
There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa .
PURPOSE OnabotulinumtoxinA ( BoNT-A ) is a promising therapy for treating neurogenic detrusor overactivity ( NDO ) in individuals with spinal cord injury ( SCI ) .
This systematic review and meta- analysis aim ed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI .
Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions.
OBJECTIVE To evaluate botulinum toxin type A ( BTX-A ) for treating neurogenic detrusor overactivity in patients with spinal cord lesions , including those with abnormally low bladder compliance . DESIGN Nonr and omized , before-after trial ( 9-mo follow-up ) . SETTING Hospitalized care . PARTICIPANTS Ten patients with high detrusor contraction pressure and /or poor response to oxyphencyclimine with incontinence selected as a consecutive sample . INTERVENTION BTX-A ( Botox ; 300U ) was injected into the detrusor muscle . MAIN OUTCOME MEASURES Urinary continence , functional bladder capacity , bladder compliance , detrusor contraction pressure , and volume at first reflex voiding . Measurements were taken before and 6 , 16 , and 36 weeks posttreatment . RESULTS Six weeks after treatment , complete continence was restored in 7 patients without oxyphencyclimine .  Mean functional bladder capacity ( P=.008 ) , compliance ( P=.012 ) , and reflex volume ( P=.045 ) significantly increased , whereas maximal detrusor contraction pressure significantly decreased ( P<.001 ) . Urodynamic variables remained significantly improved at 16 weeks , but values were returning toward baseline levels by 36 weeks . The procedure was generally uneventful , without any serious side effects . CONCLUSIONS BTX-A injections are an effective , well-tolerated treatment for neurogenic detrusor overactivity in patients with spinal cord lesions , even in patients with abnormally low bladder compliance . Patients may require repeat injections after 16 weeks to remain continent
There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa .
CONCLUSION BoNT-A is effective and safe in treating NDO after SCI .
There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa .
PURPOSE OnabotulinumtoxinA ( BoNT-A ) is a promising therapy for treating neurogenic detrusor overactivity ( NDO ) in individuals with spinal cord injury ( SCI ) .
This systematic review and meta- analysis aim ed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI .