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Response to ‘Onabotulinum toxin injection in neurogenic detrusor overactivity: intradetrusor versus suburothelial’

We want to thank Dr Burki and Dr Hamid1 for positive comments with regard to our study and for their constructive critique.2

We acknowledge that correct way to express the dose of onabotulinum toxin is using Allergan Units U.

We agree that it might be difficult to perform suburothelial injection with absolute certainty in every instance. However, we feel that it is possible to know with certainty that the injection has been performed suburothelialy. As our study had documented that there is no statistically significant difference between the two modes of drug administration, the certainty with regard to the depth of injection is not necessary. We however predict that suburothelial administration is safer than intramuscular, as it is administrated under visual control. Although current study does not include large enough sample size to support this conclusion, we are addressing the complication rate in the ongoing study.

With regard to the conflict of interest, we want to confirm our original disclaimer that none of the authors has any conflict of interest. The statement that the second author has been a consultant for Allergan and an invited lecturer for Pfizer, Astellas and Wellspect Healthcare is incorrect.


  1. 1

    Burki JR, Hamid R . Onabotulinum toxin injection in neurogenic detrusor overactivity: intradetrusor versus suburothelial. Spinal Cord 2013; 51: 725.

    CAS  Article  Google Scholar 

  2. 2

    Krhut J, Samal V, Nemec D, Zvara P . Intradetrusor versus suburothelial onabotulinumtoxinA injections for neurogenic detrusor overactivity: a pilot study. Spinal Cord 2012; 50: 904–907.

    CAS  Article  Google Scholar 

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Correspondence to J Krhut.

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Krhut, J., Samal, V., Nemec, D. et al. Response to ‘Onabotulinum toxin injection in neurogenic detrusor overactivity: intradetrusor versus suburothelial’. Spinal Cord 51, 726 (2013).

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