Summary by Rizwan Hamid
The potential uses of Botulinum toxin A in lower urinary tract dysfunction continue to expand. Panicker et al reported the first open label study for the use of Botulinum toxin in females with primary disorder of sphincter relaxation. They demonstrated an improvement in patient reported outcome measures and in objective parameters. They recommend this technique as an interim measure in patients awaiting sacral neuromodulation.
The health economics continue to influence our practice. In an interesting study Zyczynski and colleagues compared the cost effectiveness of onabotulinum toxin A and anticholinergic medications for the treatment of urgency incontinence in a double blind double placebo controlled trial. They concluded that both effectiveness and cost is similar for both treatments at 6 months but the outcomes at 9 months favour Botox.
Sacral neuromodulation is an established treatment modality for bladder dysfunction. Dandolu and associate evaluated a population based cross sectional study for a decade. They reported that over a period of time almost 1 in 4 implants will either be removed or replaced. They concluded that this is much higher than previously reported.
Lastly, Gomes et al reported on female sexual dysfunction after spinal cord injury. They concluded that it is severely affected and leads to a negative impact on quality of life.
The session as very well attended and there was lively interactive discussion on all presentations.