Chen Sheng-Fu, Kuo Hann-Chorng
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2020 Jul 29;33(2):101-107. doi: 10.4103/tcmj.tcmj_77_20. eCollection 2021 Apr-Jun.
Chronic spinal cord injury (SCI) can induce neurogenic detrusor overactivity (NDO), leading to urinary incontinence and renal damage due to low bladder compliance and high detrusor pressure during the storage and voiding of urine. In 2011, Botox (onabotulinumtoxinA, botulinum neurotoxin serotype A [BoNT-A]) was approved by the Food and Drug Administration for the treatment of NDO. Intradetrusor injection of BoNT-A has been shown to have clinical utility for the treatment of urinary incontinence, with consequent improvements in quality of life for patients. In the past 20 years, this treatment has been shown to be an effective treatment for patients with SCI refractory to antimuscarinic medication. The present review focused on publications in MEDLINE/PubMed relating to botulinum toxin to evaluate the treatment outcomes of repeated injection of BoNT-A, the mechanisms of action, results of clinical and urodynamic studies, and adverse effects.
慢性脊髓损伤（SCI）可诱发神经源性逼尿肌过度活动（NDO），由于在尿液储存和排尿期间膀胱顺应性低和逼尿肌压力高，导致尿失禁和肾损伤。2011年，肉毒杆菌毒素（onabotulinumtoxinA，A型肉毒杆菌神经毒素[BoNT-A]）被美国食品药品监督管理局批准用于治疗NDO。膀胱内注射BoNT-A已被证明对治疗尿失禁具有临床效用，从而改善患者的生活质量。在过去20年中，这种治疗方法已被证明对对抗毒蕈碱药物难治的SCI患者是一种有效的治疗方法。本综述重点关注MEDLINE/PubMed中与肉毒杆菌毒素相关的出版物，以评估重复注射BoNT-A的治疗效果、作用机制、临床和尿动力学研究结果以及不良反应。
