Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors
External urethral sphincter (EUS) dysfunction is a common, bothersome female voiding dysfunction. This study aims to analyze the characteristics of different types of female EUS dysfunction, as well as to determine the outcome predictors of sphincteric botulinum toxin A (BoNT-A) injection. Women rec...
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MDPI AG
2021-06-01
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| Online Access: | https://www.mdpi.com/2072-6651/13/6/398 |
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| author | Yin-Chien Ou Kuan-Hsun Huang Hau-Chern Jan Hann-Chorng Kuo Yao-Lin Kao Kuen-Jer Tsai |
| author_facet | Yin-Chien Ou Kuan-Hsun Huang Hau-Chern Jan Hann-Chorng Kuo Yao-Lin Kao Kuen-Jer Tsai |
| author_sort | Yin-Chien Ou |
| collection | DOAJ |
| description | External urethral sphincter (EUS) dysfunction is a common, bothersome female voiding dysfunction. This study aims to analyze the characteristics of different types of female EUS dysfunction, as well as to determine the outcome predictors of sphincteric botulinum toxin A (BoNT-A) injection. Women receiving sphincteric BoNT-A injections for refractory EUS dysfunction were retrospectively reviewed. A comparison of the baseline clinical, urodynamic parameters and the treatment responses were made for patients with different EUS dysfunctions. A total of 106 females were included. Significantly increased detrusor overactivity, detrusor contracting pressure and the bladder outlet obstruction index with decreased urge sensation were noted in patients diagnosed with dysfunctional voiding or detrusor sphincter dyssynergia comparing to those diagnosed with poor relaxation of the external urethral sphincter. The average subjective improvement rate was 67% for the injection. The therapeutic effect was not affected by the type of EUS dysfunction. The multivariate analysis revealed that bladder neck narrowing and catheterization history were predictive of negative outcomes. There is a distinct urodynamic presentation for each type of female EUS dysfunction. Sphincteric BoNT-A injection provides a good therapeutic outcome for refractory EUS dysfunction. A narrowing bladder neck and a history of catheterization suggest poor therapeutic outcomes. |
| first_indexed | 2024-03-10T10:46:30Z |
| format | Article |
| id | doaj.art-0b42bc268f5e48b5afc45d720112b73e |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T10:46:30Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-0b42bc268f5e48b5afc45d720112b73e2023-11-21T22:32:35ZengMDPI AGToxins2072-66512021-06-0113639810.3390/toxins13060398Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive FactorsYin-Chien Ou0Kuan-Hsun Huang1Hau-Chern Jan2Hann-Chorng Kuo3Yao-Lin Kao4Kuen-Jer Tsai5Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanDepartment of Urology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, TaiwanDivision of Urology, Department of Surgery, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin 640, TaiwanDepartment of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, TaiwanDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 704, TaiwanExternal urethral sphincter (EUS) dysfunction is a common, bothersome female voiding dysfunction. This study aims to analyze the characteristics of different types of female EUS dysfunction, as well as to determine the outcome predictors of sphincteric botulinum toxin A (BoNT-A) injection. Women receiving sphincteric BoNT-A injections for refractory EUS dysfunction were retrospectively reviewed. A comparison of the baseline clinical, urodynamic parameters and the treatment responses were made for patients with different EUS dysfunctions. A total of 106 females were included. Significantly increased detrusor overactivity, detrusor contracting pressure and the bladder outlet obstruction index with decreased urge sensation were noted in patients diagnosed with dysfunctional voiding or detrusor sphincter dyssynergia comparing to those diagnosed with poor relaxation of the external urethral sphincter. The average subjective improvement rate was 67% for the injection. The therapeutic effect was not affected by the type of EUS dysfunction. The multivariate analysis revealed that bladder neck narrowing and catheterization history were predictive of negative outcomes. There is a distinct urodynamic presentation for each type of female EUS dysfunction. Sphincteric BoNT-A injection provides a good therapeutic outcome for refractory EUS dysfunction. A narrowing bladder neck and a history of catheterization suggest poor therapeutic outcomes.https://www.mdpi.com/2072-6651/13/6/398botulinum toxinurethral sphinctervoiding dysfunctionfemale |
| spellingShingle | Yin-Chien Ou Kuan-Hsun Huang Hau-Chern Jan Hann-Chorng Kuo Yao-Lin Kao Kuen-Jer Tsai Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors Toxins botulinum toxin urethral sphincter voiding dysfunction female |
| title | Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors |
| title_full | Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors |
| title_fullStr | Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors |
| title_full_unstemmed | Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors |
| title_short | Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors |
| title_sort | therapeutic efficacy of urethral sphincteric botulinum toxin injections for female sphincter dysfunctions and a search for predictive factors |
| topic | botulinum toxin urethral sphincter voiding dysfunction female |
| url | https://www.mdpi.com/2072-6651/13/6/398 |
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