• Brigitte Schurch, Marianne de Sèze, Pierre Denys, Emmanuel Chartier-Kastler, Francois Haab, Karel Everaert, Pierre Plante, Brigitte Perrouin-Verbe, Catherine Kumar, Stephanie Fraczek, Mitchell F Brin, and Botox Detrusor Hyperreflexia Study Team.
• Spinal Cord Injury Centre, University Hospital Balgrist, Zurich, Switzerland. schurdhb@balgrist.unizh.ch
• J. Urol. 2005 Jul 1; 174 (1): 196-200.

PurposeWe determined the safety and efficacy of each of 2 doses of botulinum toxin type A (BTX-A) (200 or 300 U BOTOX) injected into the detrusor for urinary incontinence caused by neurogenic detrusor overactivity of predominantly spinal cord origin.Materials And MethodsA total of 59 patients with urinary incontinence caused by neurogenic detrusor overactivity (due to spinal cord injury in 53 and multiple sclerosis in 6) requiring clean intermittent self-catheterization were randomized to receive a single dose into the detrusor of BTX-A (200 U or 300 U) or placebo. Changes in daily frequency of urinary incontinence episodes were monitored via a patient bladder diary during 24 weeks. Key urodynamic assessments (maximum cystometric capacity, reflex detrusor volume and maximum detrusor pressure during bladder contraction) were used to provide objective measures of the treatment effect on bladder function. The impact of treatment on quality of life was assessed using the Incontinence Quality of Life questionnaire.ResultsThere were significant posttreatment decreases in incontinence episodes from baseline in the 2 BTX-A groups (p ConclusionsIntramuscular injections of BTX-A into the detrusor can provide rapid, well tolerated, clinically significant decreases in the signs and symptoms of urinary incontinence caused by neurogenic detrusor overactivity during a 24-week study period.

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