The Lowest Effective Dose of Botulinum Toxin in Detrusor Sphincter Dyssynergia

In a study conducted 15 years ago, the lowest effective dose of botulinum toxin type A (BOTOX) for the treatment of detrusor sphincter dyssynergia was investigated. Detrusor sphincter dyssynergia is a condition characterized by a lack of coordination between the bladder and the external sphincter, leading to high bladder pressures and incomplete bladder emptying. The study was a prospective, randomized, double-blind, dose-ranging clinical trial with 12 adult patients divided into three groups of four, each receiving either 50, 75, or 100 units (U) of BOTOX. The results showed that both 75 and 100 U significantly reduced post-voiding residual urine and detrusor pressure (P<0.05), with the 100 U group showing the most reduction. The conclusion was that the lowest effective dose of BOTOX for this condition is between 75-100 U, which is slightly lower than doses reported in other studies.