ABSTRACT
Compensated bladder storage is a function that is decisive for the quality of life and life expectancy of patients with neurogenic lower urinary tract dysfunction. It is characterized by low-pressure storage with physiologic storage pressure at an adequate volume as the maximum value. Two prerequisites are fundamental: intact detrusor musculature and satisfactory management of bladder emptying, preferably by intermittent catheterization. In principle, to normalize the detrusor muscle its nervous supply can be altered by chemical receptor blockers, such as botulinum A toxin, which is the simplest and most promising method of ensuring compensated storage. Three varieties of botulinum A toxin are available: Botox®, Dysport®, and Xeomin®. Concerning the use for detrusor injections, no data about Xeomin are available. The bladder anterior wall and dome are approached, and the peritoneum is freed from the bladder until about halfway down the bladder posterior wall.
