Marte Antonio
Department of Woman, Child and General and Specialized Surgery, University of Campania, Naples, ITA.
Cureus. 2025 Jun 30;17(6):e87034. doi: 10.7759/cureus.87034. eCollection 2025 Jun.
Botulinum toxin (BoNT) injections into the bladder wall have become a well-established treatment for various bladder disorders, particularly neurogenic detrusor overactivity (NDO) and overactive bladder (OB) in both adults and children. However, challenges persist with injection techniques, as up to 40% of BoNT can inadvertently be injected into the extravesical space, leading to reduced treatment efficacy. There are two primary methods for administering BoNT: submucosal and intravesical injections, each employing distinct techniques to ensure precise drug delivery. A novel technique referred to as mucosal lifting was evaluated in 20 young patients with NDO. This method is a modification of the traditional submucosal injection technique, where the bladder mucosa is lifted to create a suitable space for injection. Results demonstrated a significant increase in dryness time between clean intermittent catheterizations, with an average improvement from 8.9 months to 11.8 months, indicating enhanced efficacy. Despite these encouraging findings, the small sample size limits the generalizability of the study's conclusions.
向膀胱壁注射肉毒杆菌毒素（BoNT）已成为治疗各种膀胱疾病的成熟方法，尤其是成人和儿童的神经源性逼尿肌过度活动症（NDO）和膀胱过度活动症（OB）。然而，注射技术方面仍然存在挑战，因为高达40%的BoNT可能会无意中注入膀胱外间隙，导致治疗效果降低。施用BoNT有两种主要方法：黏膜下注射和膀胱内注射，每种方法都采用不同的技术来确保精确给药。在20名患有NDO的年轻患者中评估了一种称为黏膜提升的新技术。这种方法是对传统黏膜下注射技术的改进，即提起膀胱黏膜以创造合适的注射空间。结果显示，清洁间歇性导尿之间的干燥时间显著增加，平均从8.9个月提高到11.8个月，表明疗效增强。尽管有这些令人鼓舞的发现，但样本量较小限制了该研究结论的普遍性。
