Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan.
School of Medicine, China Medical University, Taichung 40402, Taiwan.
Toxins (Basel). 2023 Mar 4;15(3):199. doi: 10.3390/toxins15030199.
Owing to the diverse treatment outcomes after a botulinum toxin A (BoNT-A) injection to the external sphincter, this study aimed to develop a new technique: an ultrasound-guided BoNT-A external sphincter injection. This single-center prospective cohort study was conducted at a tertiary medical center in Taichung, Taiwan. From December 2020 to September 2022, 12 women were enrolled. The patients were evaluated for lower urinary tract syndrome using patient perception of bladder condition (PPBC), international prostate symptom score (IPSS), uroflowmetry, post-void residual volume (PVR), cystometry, and external sphincter electromyography. We evaluated the patients the day before surgery and 1 week after the BoNT-A injection. For the patients requiring self-catheterization, we recorded the number of times they required clean intermittent catheterization (CIC) per day before the procedure and 1 month after the procedure. The IPSS, PPBC, and PVR were significantly better after the transvaginal ultrasound-guided BoNT-A external sphincter injection. The number of times the patients required daily CIC was also reduced after the injection. Only one patient developed de novo urge urinary incontinence. Our results demonstrated that a transvaginal ultrasound-guided BoNT-A injection was efficacious and safe in the treatment of underactive bladder.
由于肉毒杆菌毒素 A（BoNT-A）注射到外括约肌后的治疗效果各异，本研究旨在开发一种新的技术：超声引导 BoNT-A 外括约肌注射。这项单中心前瞻性队列研究在台湾台中的一家三级医疗中心进行。2020 年 12 月至 2022 年 9 月，共纳入 12 名女性患者。通过患者对膀胱状况的感知评估（PPBC）、国际前列腺症状评分（IPSS）、尿流率、残余尿量（PVR）、膀胱测压和外括约肌肌电图评估患者的下尿路综合征。我们在手术前一天和 BoNT-A 注射后 1 周对患者进行评估。对于需要自行导尿的患者，我们记录了他们在术前和术后 1 个月每天需要清洁间歇性导尿（CIC）的次数。经阴道超声引导 BoNT-A 外括约肌注射后，IPSS、PPBC 和 PVR 明显改善。注射后，患者每日需要 CIC 的次数也减少了。只有 1 名患者出现新发急迫性尿失禁。我们的研究结果表明，经阴道超声引导 BoNT-A 注射治疗膀胱活动低下是有效且安全的。
