THE EFFECT OF THE FIRST INTRADETRUSOR BOTULINUM TOXIN INJECTION ON FUNCTIONAL INDEPENDENCE, QUALITY OF LIFE, PAIN AND SPASMS IN INDIVIDUALS WITH SPINAL CORD INJURY

Abstract

After a spinal cord injury (SCI) practically all patients experience neurogenic bladder dysfunction. The botulinum toxin type A is a procedure for treating urological complications in these patients. The objective this study was to analyze whether individuals with traumatic SCI have improved functionality, quality of life (QoL), pain, and spasms after the first application of intradetrusor botulinum toxin type A. A prospective longitudinal observational study was developed with twenty patients with traumatic SCI followed up in a rehabilitation center. The patients were evaluated before, one and four months after the first application of intradetrusor botulinum toxin type A. The instruments used were: Spinal Cord Independence Measure III (SCIM III) and Qualiveen-SF, to assess functionality and QoL, respectively; Numeric Rating Scale for pain assessment and the Penn Scale to assess the spasms. Descriptive and inferential (p <0.05) statistics were perfomed. Of the patients evaluated, 90% were men, and 80% had paraplegia. In the first month after applying botulinum toxin type A, there was improvement in the domain related to sphincter control of SCIM III (p=0.02). There was no statistically significant difference in the QoL, pain intensity, frequency and severity of spasms before application of botulinum toxin and after 1 and 4 months (p>0.05). The first application of intradetrusor botulinum toxin type A interfered positively functional independence related to sphincter control in the first month after application, but did not influence the pain, spasm and QoL.