RESUMO
Objective: To evaluate the clinical outcome of botulinum A toxin (BTX-A) injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia (DESD) after spinal cord injury (SCI). Methods: A total of 38 urodynamic examination-confirmed DESD patients, male 31 and female 7, with an average age of (36.5 ± 17.8) years old, were included in this study. 200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites (1 ml per site) of the external sphincter via a 5F flexible cystoscopic needle. On the second day, 9 patients (BTX-A + baclofen group) were randomly selected for baclofen oral administration, 3/d for 3 months, the other 26 patients were taken as control. Urodynamic examination was repeated in all patients 4 weeks later; the voiding diary and urodynamic outcomes were compared before and after treatment. The adverse and toxic effects were observed in the patients who were followed up for 2-9 months. Results: One month after treatment the voiding and storing functions of bladder were improved to different degrees, with the mean maximum uroflow rate (Qmax), the mean urine volume, the mean maximal eystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly (all P
RESUMO
@# Objective To explore the technique,efficacy and complications of external sphincterotomy with Holmium laser for the treatment of detrusor external sphincter dyssynergia (DSD). Methods 7 male cases with neurogenic DSD who received the procedure were reported. Results All patients got significant improvement after the operation in symptoms,laboratory,imaging and urodynamic index. No one required transfusion. 1 case lost the erection. There was no need of re-operation during the follow-up. Conclusion External sphincterotomy with Holmium laser for the treatment of DSD shows the advantages of less bleeding,safety and good effectiveness for the well selected patients.
RESUMO
Objective:To evaluate the clinical outcome of botulinum A toxin(BTX-A)injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia(DESD)after spinal cord injury(SCI). Methods:A total of 38 urodynamic examination-confirmed DESD patients,male 31 and female 7,with an average age of (36.5?17.8)years old,were included in this study.200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites(1 ml per site)of the external sphincter via a 5F flexible cystoscopic needle.On the second day,9 patients(BTX-A+baclofen group)were randomly selected for baclofen oral administration,3/d for 3 months; the other 26 patients were taken as control.Urodynamic examination was repeated in all patients 4 weeks later;the voiding diary and urodynamic outcomes were compared before and after treatment.The adverse and toxic effects were observed in the patients who were followed up for 2-9 months.Results:One month after treatment the voiding and storing functions of bladder were improved to different degrees,with the mean maximum uroflow rate(Qmax),the mean urine volume,the mean maximal cystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly(all P