Fowler Clare J
Institute of Neurology, University College London, UK; Consultant, National Hospital for Neurology & Neurosurgery, London, UK.
Can Urol Assoc J. 2011 Oct;5(5 Suppl 2):S146-8. doi: 10.5489/cuaj.11187.
While many neurologic diseases predispose patients to neurogenic detrusor overactivity (NDO), the only populations that have been systematically studied are adults with multiple sclerosis (MS), adults with spinal cord injury (SCI) and children and young adults with myelodysplasia. First-line pharmacotherapy for NDO is an anti-muscarinic drug. However, the evidence base for these agents in this indication is poor. There is some high-quality evidence for the efficacy of detrusor injections of botulinum toxin A in the treatment of NDO, with significant reduction in urgency incontinence episodes, improved urodynamic parameters, and improved quality of life. While few adverse events have been reported with this therapy, there is a need for intermittent self-catheterization in these groups.
虽然许多神经系统疾病使患者易患神经源性逼尿肌过度活动（NDO），但仅对患有多发性硬化症（MS）的成年人、脊髓损伤（SCI）的成年人以及患有脊髓发育不良的儿童和青年进行了系统研究。NDO的一线药物治疗是抗毒蕈碱药物。然而，这些药物在此适应症方面的证据基础薄弱。有一些高质量证据表明，注射肉毒杆菌毒素A治疗NDO有效，可显著减少急迫性尿失禁发作次数，改善尿动力学参数，并提高生活质量。虽然该疗法报告的不良事件较少，但这些患者群体需要间歇性自我导尿。
