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Titre : | A Meta-Analysis of Botulinum Toxin Sphincteric Injections in the Treatment of Incomplete Voiding After Spinal Cord Injury (2012) |
Auteurs : | S. Mehta ; D. Hill ; Norine Foley |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2012/4, 2012) |
Article en page(s) : | pp 597-603 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Rééducation et réadaptation ; Traumatismes de la moelle épinière |
Mots-clés: | Bladder ; Botulinum toxin ; Spinal cord injuries ; Vessie urinaire ; Toxines botuliniques |
Résumé : |
Objective To conduct a systematic review and meta-analysis to examine the effect of injecting botulinum toxin A (BTX-A) into the detrusor sphincter on improving bladder emptying in individuals with spinal cord injury (SCI). Data Sources MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched for all relevant articles published from 1980 to September 2011. Data Selection All trials examining the use of BTX-A injections into the detrusor sphincter for the treatment for incomplete bladder emptying after SCI were included if at least 50% of the study sample comprised subjects with SCI, and if the SCI sample size was 3 or greater. Data Extraction A standardized mean difference (SMD) + SE and 95% confidence interval (CI) were calculated for each outcome of interest, and the results were pooled using a fixed or random effects model, as appropriate. Outcomes assessed included postvoid residual urine volume (PRV), detrusor pressure (PDet), and urethral pressure (UP). Effect sizes were interpreted as small, 0.2; moderate, 0.5; and large, 0.8. Data Synthesis A relatively limited number of studies (2 randomized controlled trials, 6 uncontrolled trials) were identified. The 8 studies included results from 129 subjects. There was a statistically significant decrease in PRV at 1 month (SMD=1.119+.140; 95% CI, .8441.394; P<.001 with a pooled mean prv decrease from to there was moderate statistical effect on pdet ci .145 p=".009);" decreased large size up .327 and an improvement were seen. the systematic review also indicated reduction in urinary tract infections based studies. discontinuation or catheter usage reported studies after btx-a.> Conclusions Results of the meta-analysis indicate that BTX-A is effective in reducing PRV and demonstrating a statistically significant reduction in PDet and UP 1 month postinjection. However, the clinical utility of BTX-A is yet to be determined. |
Disponible en ligne : | Oui |
En ligne : | http://www.archives-pmr.org/article/S0003-9993%2811%2900993-2/abstract |