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Botulinum Toxin for Neurogenic Detrusor Overactivity

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Botulinum Toxin in Urology

Abstract

Patients with neurogenic bladder dysfunction suffer from detrusor overactivity (detrusor hyperreflexia), which may be combined with detrusor sphincter dyssynergia (DSD; uncoordinated voiding). Both conditions cause high intravesical pressure and can lead to upper urinary tract damage.

Normal micturition is based on synergy between a functional bladder and a competent urethral sphincter. The bladder must function to store and empty urine properly, and the neural control resides in the pons and the suprapontine regions of the brain stem to switch between these two modes efficiently and appropriately. Neurogenic detrusor overactivity (NDO) occurs in upper motor neuron diseases or injury with lesions above the sacral spinal cord bladder ­micturition center. For those with spinal cord lesions, DSD or uncoordinated micturition between the bladder and sphincter may occur (Fig. 3.1). This conditions can cause high intravesical pressure and can lead to upper urinary tract damage.

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Authors and Affiliations

  1. Department of Urology, Oakland University, Willam Beaumont School of Medicine, Royal Oak, MI, 48073, USA

    Dr. Michael B. Chancellor

  2. The Scott Department of Urology, Baylor College of Medicine, Houston, TX, 77030, USA

    Dr. Christopher P. Smith

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  1. Dr. Michael B. Chancellor
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  2. Dr. Christopher P. Smith
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Correspondence to Michael B. Chancellor .

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© 2011 Springer-Verlag Berlin Heidelberg

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Chancellor, M.B., Smith, C.P. (2011). Botulinum Toxin for Neurogenic Detrusor Overactivity. In: Botulinum Toxin in Urology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03580-7_3

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  • DOI: https://doi.org/10.1007/978-3-642-03580-7_3

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-03579-1

  • Online ISBN: 978-3-642-03580-7

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