Transuethral injection of botulinum A toxin into the urethral sphincter in patients with functional bladder outlet obstruction

ABSTRACT

Botulinum A toxin [BTX-A] injection into the external urinary sphincter has been reported in men with detrusor-sphincter dyssynergia [DSD] in few recent studies. Botulinum A toxin injection into external urethral sphincter to paralyze it and to relieve urethral obstruction was reported as a new mode of treatment to reduce infra-vesical resistance in cases of functional obstruction. The present study investigated the effect of injection of Botulinum A toxin into the external urinary sphincter to improve voiding in patients with functional bladder outlet obstruction. 7 patients [78%] showed a significant subjective and objective improvement in voiding patterns compared to that of their pre-operative condition. Botulinium toxin injection is a safe, reversible, conserative option in the treatment of functional infra-vesical obstruction. The effect of the toxin is of short-duration and requires successive injections before reaching a satisfactory long-term improvement in voiding pattern