A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging.

Détails

ID Serval
serval:BIB_9BCFD3D7339F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging.
Périodique
World Journal of Urology
Auteur(s)
Mehnert U., Boy S., Schmid M., Reitz A., von Hessling A., Hodler J., Schurch B.
ISSN
1433-8726 (Electronic)
ISSN-L
0724-4983
Statut éditorial
Publié
Date de publication
2009
Volume
27
Numéro
3
Pages
397-403
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVES: Although botulinum neurotoxin type A (BoNT/A) intradetrusor injections are a recommended therapy for neurogenic detrusor overactivity (NDO), refractory to antimuscarinic drugs, a standardisation of injection technique is missing. Furthermore, some basic questions are still unanswered, as where the toxin solution exactly spreads after injection. Therefore, we investigated the distribution of the toxin solution after injection into the bladder wall, using magnet resonance imaging (MRI).
METHODS: Six patients with NDO were recruited. Three of six patients received 300 U of BoNT/A + contrast agent distributed over 30 injection sites (group 1). The other three patients received 300 U of BoNT/A + contrast agent distributed over 10 injection sites (group 2). Immediately after injection, MRI of the pelvis was performed. The volume of the detrusor and the total volume of contrast medium inside and outside the bladder wall were calculated.
RESULTS: In all patients, a small volume (mean 17.6%) was found at the lateral aspects of the bladder dome in the extraperitoneal fat tissue, whereas 82.4% of the injected volume reached the target area (detrusor). In both groups there was a similar distribution of the contrast medium in the target area. A mean of 33.3 and 25.3% of the total detrusor volume was covered in group 1 and 2, respectively. Six weeks after injection, five of six patients were continent and showed no detrusor overactivity in the urodynamic follow-up. No systemic side effects were observed.
CONCLUSIONS: Our results provide morphological arguments that the currently used injection techniques are appropriate and safe.
Mots-clé
Administration, Intravesical, Adolescent, Adult, Aged, Aged, 80 and over, Botulinum Toxins, Type A/administration & dosage, Botulinum Toxins, Type A/pharmacokinetics, Humans, Injections, Intramuscular, Magnetic Resonance Imaging, Neurotoxins/administration & dosage, Neurotoxins/pharmacokinetics, Tissue Distribution, Urinary Bladder/pathology, Urinary Bladder, Neurogenic/drug therapy, Urinary Bladder, Neurogenic/pathology
Pubmed
Web of science
Création de la notice
05/11/2014 13:12
Dernière modification de la notice
20/08/2019 16:02
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