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 A detrusor injections in patients with neurogenic detrusor overactivity significantly decrease the incidence of symptomatic urinary tract infections.
OBJECTIVES To study the effect of botulinum toxin A ( BoNTA ) injections into the detrusor muscle on the incidence of symptomatic urinary infections in patients with neurogenic detrusor overactivity . METHODS Between February 2004 and June 2005 , 30 patients ( 18 men , 12 women ) , mean age 39.4+/-12.1 yr , with neurogenic detrusor overactivity received an injection of 300 U Botox ( Allergan Inc. , Irvine , CA , USA ) into the detrusor .  Fifteen patients had multiple sclerosis , 14 had spinal cord injury , and 1 had myelitis . Twenty-two patients had urinary incontinence . Patients were either resistant to anticholinergic medications , had discontinued treatment because of adverse effects , or had contraindications to anticholinergic drugs . Before and 6 wk after injection , each patient kept a bladder diary and underwent urodynamic investigation , retro grade and voiding cystourethrography , and urine culture . All symptomatic urinary infections ( pyelonephritis , orchitis , prostatitis ) occurring in the 6 mo before and the 6 mo after injection were recorded . RESULTS Before injection , the mean number of symptomatic urinary infections over 6 mo was 1.75+/-1.87 . After injection , the mean was 0.2+/-0.41 ( p=0.003 ) , and only 3 patients presented symptomatic urinary infections . These patients were those who showed less improvement in their urodynamic parameters after injection ( volume of the first uninhibited contraction , maximum bladder pressure , and maximum cystometric capacity , respectively ; p=0.0037 , p=0.0002 , p=0.0027 , ANOVA ) . CONCLUSIONS BoNTA injections into the detrusor muscle significantly decreased the incidence of symptomatic urinary infections . This effect seems to be related to improvement in urodynamic parameters , reflecting improved reservoir capacity at low pressure
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 .