Efficacy of botulinum-A toxin in adults with neurogenic overactive bladder: initial results.
Bibliographic record
Abstract
INTRODUCTION AND OBJECTIVES: To study the effects of intradetrusor botulinum-A toxin (BTA) (BOTOX) injections in adult patients with detrusor overactivity who failed to respond to anticholinergic medications or developed intolerable side-effects. MATERIALS AND METHODS: Ten patients (average age 41 years, range 19-76 years) with neurogenic bladder and detrusor overactivity who were using clean intermittent catheterization 4 to 7 times a day with anticholinergic therapy were included in our study. Their history, physical examination, abdominal ultrasound, urine analysis, serum creatinine and electrolytes, as well as multichannel urodynamic evaluation were documented before administration of BTA injections. Anticholinergic medication was stopped at the time of injection. Three hundred to 400 U of BTA were injected into 30 to 40 different sites in the detrusor muscle under cystoscopic guidance. Clinical assessment and urodynamic testing were repeated 3 months after injection. RESULTS: Five patients were tetraplegic and five were paraplegic at the thoracic or lumbar level. Three patients had incontinence episodes between catheterizations before treatment, and only one patient continued to have incontinence episodes between catheterizations after treatment. Reflex volume increased by 63.08% from 180 +/- 44.99 ml to 293.7 +/- 208.42 ml (p < 0.02). Maximal bladder capacity was augmented by 73.63% from 290 +/- 131.64 ml to 518.20 +/- 273.35 ml (p < 0.03). Maximal detrusor pressure decreased by 15.52% from 69.60 +/- 39.19 cmH(2)O to 58.80 +/- 33.95 cmH(2)O (p < 0.2). No patients complained of side effects. CONCLUSION: BTA appears to be an effective and safe therapeutic option for overactive bladder in patients with spinal cord injury failing anticholinergic therapy and delays more invasive treatments. These initial results confirm European literature reports.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".