Ultrasound–Guided Botulinum Toxin Injection For Treatment Of Detrusor External Sphincter Dyssynergia

Objective：To evaluate the effects of a ultrasound（TRUS）–guidedtransperineal injection of botulinum toxin（BTX）to the external urethralsphincter（EUS） for treating detrusor external sphincter dyssynergia（DESD）.Methods： Patients （N=23） with detrusor external sphincterdyssynergia after spinal cord injury is selected，under the guide of analultrasound（female vaginal ultrasound），a dose of100U botulinum toxin wasapplied into the EUS via transperineal route injection to ease the tension ofthe EUS. Record short form of a Urinary Quality of Life Questionnaire（SF-Qualiveen），urodynamic indicators，including maximum detrusorpressure（Pdetmax）， maximum urethral pressure（MUP）， maximum flowrate（Qmax） and detrusor leak point pressure（DLPP） before treatment and4weeks later. Record postvoid residual（PVR） before treatment and1weeklater，4weeks later，24weeks later，respectively.Results:Positive clinicaloutcomes were observed in all23patients in this study. SF-Qualiveenimproved from21.074±4.018to17.852±3.860，maximum urethral pressureimproved from108.304±24.044cmH₂O to83.957±13.950cmH₂O，maximumflow rate improved from7.978±2.425ml/s to11.400±3.126ml/s，maximumdetrusor pressure improved from74.304±17.587cmH₂O to69.130±14.793cmH₂O， detrusor leak point pressure improved from59.522±14.884cmH₂O to56.435±17.215cmH₂O. Postvoid residual improved from246±84ml to188±72ml，135±63ml，221±76ml （p<0.05）.Conclusions:TRUS-guided transperineal injection of BTX has beneficial effects in treatingDESD.