NEW ORLEANS, LA USA (UroToday.com) - Dr. Renee Fougere described the scope of the problem of autonomic dysreflexia, in that 90% of patients with a spinal cord injury above T6 have some form of autonomic dysreflexia, and that the urinary bladder causes 85% of autonomic dysreflexia episodes. It is in this context that he and his group aimed to determine whether intradetrusor injection of botulinum toxin would reduce the severity of autonomic dysreflexia during urodynamics, on an ambulatory blood pressure monitoring, and/or reduce the symptoms of autonomic dysreflexia.
The seventeen subjects underwent 3 visits, including urodynamics and ambulatory blood pressure monitoring before and after botulinum toxin injection.
Patients were able to tolerate higher volumes during filling on urodynamics, and severity of autonomic dysreflexia was improved during the urodynamic studies after botulinum toxin injection. The frequency of autonomic dysreflexia episodes also decreased after the botulinum toxin injection (from 4 to 1 episode per 24 hours), and dysreflexia symptoms were also improved.
Dr. Fougere notes that typically patients are not screened during urodynamics for “silent” autonomic dysreflexia, and that the sequelae of undetected variation in blood pressure measurements in these patients are not known. These concepts could be important considerations for urologists treating neurogenic bladder patients going forward.
This study will aid clinicians in counseling spinal cord injury patients that their autonomic dysreflexia and symptoms will improve with intradetrusor botulinum toxin.
Presented by Renee Fougere at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
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Reported by Lindsey Cox (University of Michigan, Ann Arbor, MI USA), medical writer for UroToday.com