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Role of botulinum toxin in the management of multiple sclerosis lower urinary tract dysfunctions


Authors: W. Mahfouz;  J. Corcos
Authors‘ workplace: Jewish General Hospital, Canada ;  Department of Urology
Published in: Urol List 2011; 9(3): 53-57

Overview

Lower urinary tract (LUT) dysfunction is common in patients with multiple sclerosis (MS). These patients require specialized care, hospitalization and their management is a great challenge for the treatment team. Throughout the course of their disease, patients are offered different management options for treatment of incontinence and detrusor sphincter dyssynergia (DSD); the mainstay of which is antimuscarinic medications, in combination with clean intermittent self-catheterisation (CISC). The evidence for other alternative strategies aiming at improving bladder emptying is lacking and still needs more clinical trials. Botulinum toxin-A (BonT-A) has been used extensively in the management of urological manifestations of MS; as regard neurogenic detrusor overactivity (NDO) and DSD, with proven efficacy in both entities.This review will focus on the role of BonT-A in management of MS bladder and sphincteric dysfunctions, with emphasis on incidence, presentation, applications and techniques of injection of BonT-A in MS patients.

Key words:
multiple sclerosis, botulinum toxin, neurogenic detrusor overactivity, detrusor sphincter dyssynergia


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