Objective: To explore the efficacy and safety of Botulinum toxin A(BTX-A) injections combined with oral baclofen in treatment of patients with detrusor overactivity secondary to spinal cord injury (SCI)

Methods: The clinical study was conducted from July 2022 to April 2025. A total of 50 patients (mean age, 44 years; 37 males and 13 females) with detrusor overactivity secondary to SCI participated in the study. The patients received 300 U BTX-A injected into the detrusor and took 30 mg of baclofen orally, 10 mg each time, three times a day. The effective outcomes included bladder compliance (BC), the incontinence quality of life (I-QOL) score, the maximum cystometric capacity (MCC), and the maximum detrusor pressure (MDP). Adverse events were recorded.

Results: After 4 weeks of treatment, compared to the baseline data, the patients’ mean BC, I-QOL score, MDP and MCC improved significantly. The main adverse events included: hematuria (4.2%), urinary tract infection (4.5%), and mild myasthenia (5.2%).

Conclusions: The combined therapy of BTX-A and oral baclofen has demonstrated confirmed efficacy in treating spinal cord injury patients with NDO. However, further follow-up studies and observational research are needed to determine the long-term toxic side effects and whether the efficacy remains reliable for patients requiring repeated injections.