826 BOTULINUM-A TOXIN – AN ALTERNATIVE FOR INCONTINENT CHILDREN WITH THERAPY RESISTANT OVERACTIVE BLADDER?

Abstract

You have accessJournal of UrologyPediatrics: Bladder Dysfunction - Myelodysplasia, Voiding Dysfunction, Enuresis1 Apr 2011826 BOTULINUM-A TOXIN – AN ALTERNATIVE FOR INCONTINENT CHILDREN WITH THERAPY RESISTANT OVERACTIVE BLADDER? Achim Lusch, Patrick Krombach, Felix Wezel, and Maurice Stephan Michel Achim LuschAchim Lusch Mannheim, Germany More articles by this author , Patrick KrombachPatrick Krombach Mannheim, Germany More articles by this author , Felix WezelFelix Wezel Mannheim, Germany More articles by this author , and Maurice Stephan MichelMaurice Stephan Michel Mannheim, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.645AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Botulinum-A toxin is a well established medikation for neurogenic detrusor overactivity. Recent studies showed good short time results in therapy of ideopathic detrusor overactivity in adults. This prospective study included therapy resistant children with overactive bladder. METHODS 17 children (6 boys and 11 girls) with resistant non neurogenic detrusor overactivity, decreased capacity bladder for age and urge were included. All patients showed a urge incontinence as well as a enuresis. Main treatment duration before botox injection was 39 month. A dose of 100 U of botulinum-A toxin was injected in the detrusor muscle. RESULTS 12 patients (8 girls und 4 boys) showed full reponse after 1 injection (dry over the day and complete loss of urge) with a mean increase in bladder capacity from 147 to 233 ml. 3 girls and 1 boy showed a partial response – 60% decrease in incontinence over the day and urge, increase of bladder capacity from 162 ml to 251 ml (p<0,001). One boy remained unchanged. 11 of the 12 full responders were still cured after 12 month, while 1 boy showed relapse after 7 month. The 3 girls with partial response and 1 boy with relapse underwent 2nd injection with full response of the former full responder and in 2 of the former partial responders. 2 girls remained unchanged. Side effects were reported in 3 children mit temporaryly increased residual bladder volume up to 2 weeks after injection, 1 girl experienced 1 episode of symptomatic lower urinary tract infection. CONCLUSIONS Botulinum-A toxin injection in children with non-neurogenic overactive detrusor is an excellent treatment adjunct with marginal side effects and good long time results after 1 injection of 71%, after 2nd injection of 88%. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e333 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Achim Lusch Mannheim, Germany More articles by this author Patrick Krombach Mannheim, Germany More articles by this author Felix Wezel Mannheim, Germany More articles by this author Maurice Stephan Michel Mannheim, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...