Dysfunctional voiding and reflux – combined treatment with botulinum toxin A and dextranomer/hyaluronic acid

2007 ◽  
Vol 3 ◽  
pp. S18
Author(s):  
Joseph Ortenberg ◽  
Ann Tilton
Keyword(s):  
Hyaluronic Acid ◽  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Combined Treatment ◽  
Dysfunctional Voiding ◽  
Toxin A

Hyaluronic Acid Compound Filling plus Mesotherapy Versus Botulinum Toxin A for the Treatment of Horizontal Neck Lines: A Multicenter, Randomized, Evaluator-Blinded, Prospective Study in Chinese Subjects

2021 ◽  
Author(s):  
Yiming Li ◽  
Meirong Liao ◽  
Yijin Zhu ◽  
Jie Gao ◽  
Yang Song ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Botulinum Toxin ◽  
Treatment Group ◽  
Prospective Study ◽  
Botulinum Toxin A ◽  
Combined Treatment ◽  
Toxin A ◽  
Energy Devices ◽  
Patients Satisfaction ◽  
Age Related

Abstract Background Although energy devices and botulinum toxin-A (BTX-A) could alleviate the age-related laxity, ptosis, and platysmal bands, they have limited efficacy on horizontal neck lines. Objectives The purpose of this study was to investigate the efficacy, safety, and subject satisfaction of non-cross-linked hyaluronic acid (HA) compound filling plus mesotherapy combined treatment for the correction of horizontal neck lines, in comparison with BTX-A. Methods This multi-center, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to-severe horizontal neck lines corrected with either 2-3 sessions of non-cross-linked HA compound filling plus mesotherapy combined treatment or one session of BTX-A injection. Improvement of the neck lines grades, global aesthetic improvement scale (GAIS), patient satisfaction, and adverse events (AEs) were evaluated and compared on 1, 3, 6, and 10 months after the final treatment. Results Twenty-five patients received HA filling plus mesotherapy combined treatment and 23 received BTX-A injection. Compared with BTX-A, the HA compound filling plus mesotherapy combined treatment significantly improved the horizontal neck lines grades on all follow-up visits (P=0.000). Cases of different baseline grades (2, 2.5, and 3) demonstrated similar outcomes. The GAIS and patients’ satisfaction ratings were significantly higher for the HA combined treatment group (P=0.000). Significantly higher pain ratings, higher incidence, and longer recovery of AEs (erythema, edema, and ecchymosis) were noticed in the combined treatment group (P<0.001). No serious AEs occurred. Conclusions Compared with BTX-A, the HA compound filling plus mesotherapy combined treatment significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patients’ satisfaction.

scholarly journals Comparison of intravesical instillation of hyaluronic acid with intradetrusor botulinum toxin A injection or cystoscopic hydrodistention for ketamine-associated cystitis

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097310
Author(s):  
Bingkun Li ◽  
Qu Leng ◽  
Chuanyin Li ◽  
Xiao Tan ◽  
Wei Su ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Intravesical Instillation ◽  
Lower Amount ◽  
Toxin A ◽  
Symptom Index ◽  
Detrusor Contraction ◽  
Contraction Group ◽  
Maximal Capacity

Objective This study aimed to compare the therapeutic effect of intravesical instillation hyaluronic acid with intradetrusor botulinum toxin A (BTX-A) injection or cystoscopic hydrodistention for ketamine-associated cystitis. Methods Thirty-six patients were evenly randomly divided into the BTX-A group or the hydrodistention group. Patients received 200 U BTX-A detrusor injections in the BTX-A group and cystoscopic hydrodistention in the hydrodistention group. Intravesical instillation of hyaluronic acid was administrated in both groups for eight times. Patients with involuntary detrusor contraction were divided into the persistent involuntary detrusor contraction group and resolved involuntary detrusor contraction group after treatment in 6 months. The predictors of persistent involuntary detrusor contraction were analyzed. Results Twelve months after treatment, the daytime frequency, Interstitial Cystitis Symptom Index, maximal capacity, and maximal cystometric capacity in the BTX-A group were significantly better than those in the hydrodistention group. Patients with resolution of involuntary detrusor contraction had a significantly shorter duration of ketamine, lower amount of fibrosis in pathology, and higher maximal capacity than those with persistent involuntary detrusor contraction 6 months after therapy. Conclusion Intravesical instillation of hyaluronic acid with intradetrusor BTX-A injection appears to be a preferable option for long-term effectiveness compared with cystoscopic hydrodistention.

scholarly journals A Prospective Study to Evaluate the Efficacy of Botulinum Toxin-A in the Management of Dysfunctional Voiding in Women

2018 ◽  
Vol 11 ◽  
pp. 1179562X1881134
Author(s):  
Pramod Krishnappa ◽  
Maneesh Sinha ◽  
Venkatesh Krishnamoorthy
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Voiding Cystourethrogram ◽  
Maximal Flow ◽  
Detrusor Pressure ◽  
Dysfunctional Voiding ◽  
External Urethral Sphincter ◽  
Toxin A ◽  
Neurologically Normal ◽  
Proximal Urethra

Objectives: To assess the outcomes of Botulinum Toxin-A (BoNT-A) to the external urethral sphincter (EUS) in dysfunctional voiding (DV) refractory to standard urotherapy and bowel management. Methods: Our criteria to diagnose DV in women included neurologically normal individuals with lower urinary tract symptoms, dilated proximal urethra on voiding cystourethrogram, and high detrusor pressure (PdetQmax > 20 cm H2O) associated with increased electromyography activity during voiding in urodynamic study (UDS). A total of 16 female patients with a median age of 36 years (5-60 years) received BoNT-A from June 2014 to December 2015. Patients below and above 10 years of age received 100 units and 200 units of BoNT-A to EUS, respectively. Patients were followed up till 6 months. Results: Mean AUA (American Urological Association) symptom score decreased significantly from 11.75 ± 6.14 to 5.06 ± 5.1 and 4.25 ± 3.4 at day 14 and day 45 after BoNT-A, respectively ( P < .0001). There were no significant improvements in maximal flow (Qmax) on uroflowmetry (UFM) and detrusor pressure at maximal flow (PdetQmax) in UDS. Significant reduction in post-void residual (PVR) from 69.31 ± 77.3 to 17.50 ± 22.3 mL at day 14 ( P = .007) was observed, although the reduction was not significant at day 45. Although minor adverse effects were reported, none were serious or life-threatening. Conclusions: Our study showed that BoNT-A plays a role in improvement of urinary symptoms and reduces PVR at D14 in DV, but showed no improvement in UFM and urodynamic parameters, albeit with limited numbers and limited follow-up.

scholarly journals Therapeutic Effects of Urethral Sphincter Botulinum Toxin A Injection on Dysfunctional Voiding with Different Videourodynamic Characteristics in Non-Neurogenic Women

Toxins ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 362
Author(s):  
Yuan-Hong Jiang ◽  
Cheng-Ling Lee ◽  
Sheng-Fu Chen ◽  
Hann-Chorng Kuo
Keyword(s):  
Treatment Outcome ◽  
Botulinum Toxin ◽  
Successful Treatment ◽  
Therapeutic Efficacy ◽  
Botulinum Toxin A ◽  
Outlet Obstruction ◽  
Therapeutic Effects ◽  
Dysfunctional Voiding ◽  
Toxin A ◽  
Urodynamic Parameters

Although female dysfunctional voiding (DV) is common in urological practice, it is difficult to treat. This study evaluated the therapeutic efficacy of urethral botulinum toxin A (BoNT-A) on non-neurogenic female DV. Based on the videourodynamic study (VUDS), the DV was classified into three subgroups according to the obstructive site. A successful treatment outcome was defined as an improvement of voiding efficiency by 10% and reported global response assessment by ≥1. The study compared therapeutic efficacy, baseline urodynamic parameters, and changes in urodynamic parameters between the treatment success and failure groups and among three DV subgroups. Predictive factors for successful treatment were also investigated. A total of 81 women with DV were categorized into three groups: 55 (67.9%) had mid-urethral DV, 19 (23.5%) had distal urethral DV, and 7 (8.6%) had combined BN dysfunction and mid-urethral DV after BN transurethral incision. The treatment outcome was successful for 55 (67.9%) patients and failed for 26 (32.1%). Successfully treated patients had a significant decrease of detrusor pressure, post-void residual volume, and bladder outlet obstruction index, as well as an increase in voiding efficiency at follow-up versus the treatment failure group. The logistic regression of urodynamic parameters and clinical variables revealed that a greater volume of first sensation of filling predicts a successful BoNT-A treatment outcome (p = 0.047). The urethral BoNT-A injection is effective in treating non-neurogenic women with DV, with a success rate of 67.9%. The videourodynamic characteristics of DV may differ among patients but does not affect the treatment outcome.

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