SPECIAL ARTICLE  MANAGEMENT OF NEUROGENIC LOWER URINARY TRACT DYSFUNCTION Free access

European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):991-7

DOI: 10.23736/S1973-9087.17.04978-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Intradetrusor injection of botulinum toxin A and sacral neuromodulation for neurogenic detrusor overactivity

Charles JOUSSAIN ^{1, 2} ✉, Véronique PHÉ ³, Alexia EVEN ², Emmanuel CHARTIER-KASTLER ³, Pierre DENYS ^{1, 2}

¹ Medical School Paris Île-de-France Ouest, Inserm U1179, Versailles Saint-Quentin University, Versailles, France; ² Department of Physical Medicine and Rehabilitation, Raymond-Poincaré AP-HP Hospital, Garches, France; ³ Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France

Intradetrusor injection of botulinum toxin A and sacral neuromodulation are the two recommended third line treatments for patients with neurogenic detrusor overactivity, before undergoing with surgery. However, only Botox® injection is supported by a high level of evidence allowing its recommendation by all institutional guidelines. Despite few positive results, sacral neuromodulation should be proposed in carefully selected patients. Indeed, other studies remain mandatory to increase its level of evidence necessary for allowing its use in neurogenic detrusor overactivity.

KEY WORDS: Urinary incontinence - Botulinum toxins, type A - Injections