نوع مقاله : مقاله پژوهشی
1 دانشیار گروه ارولوژی / دانشگاه علوم پزشکی مشهد، ایران
2 دستیار تخصصی ارولوژی / دانشگاه علوم پزشکی مشهد، ایران
3 استاد گروه ارولوژی / دانشگاه علوم پزشکی مشهد، ایران
4 استادیار گروه ارولوژی/ فلوشیپ اندویورولوژی
عنوان مقاله [English]
Introduction:Human T Lymphocytic Virus-type 1, in 3% of carriers causes HTLV-1 Associated Myelopathy /Tropical Spastic Paraparesis. Detrusor overactivity is the most common urodynamic finding. In this study the use of botulinum-A toxin injections into the detrusor, as an alternative approach in patients with HTLV1 related detrusor overactivity who are resistant to anticholinergic therapy or with side effects of the medication, was introduced.
Materials and Methods: A total of 25 patients with HTLV1 infection and suffering from severe signs of overactive bladder who were resistant to conservative and medical treatment, had been included in this study. Urodynamic study were done, then 300 IU of botulinum toxin type A was injected into the detrusor. The reassessment and follow up were performed with urodynamic study 3 months later.
Results: Overall 20 patients ( 80%) had high Maximum Detrusor pressure, higher than normal and after the injection reduced to 4 patients ( 16%) (p< 0.001). From them, 2 patients had urinary leakage during cystometry,19 patients (76%) had Uninhibited bladder contractions and after the intervention decreased to 5 patients (20%) (p< 0.001) and from them, 2 patients had urinary leakage during cystometry.
Conclusion: Injection of botulinum neurotoxin type A showed to be effective in patients with HTLV-1 related bladder overactivity, according to the improvement of urodynamic study parametres. This treatment can have a major impact on future management of patients with resistance to anticholinergic therapy or with side effects of this medication.