Comment on: “Cost comparison of intra-detrusor injection of botulinum toxin versus augmentation cystoplasty for refractory Neurogenic Detrusor Overactivity in Children”

Abstract

To assess the outcome of treatment for a chronic ailment in pediatric patients is a very complex task. In the case of neurogenic bladder secondary to spinal dysraphism there is one major fundamental endpoint and that is preservation of kidney function. The next important goal is improvement of quality of life by achieving continence and acceptable regular bladder emptying. Two treatment modalities are widely used, augmentation cystoplasty (AC) and intravesical injections of Botulinum toxin A (BTX-A). In many instances the latter is used preceding the augmentation if kidney function is preserved to postpone the more invasive and more definitive augmentation. However, there is no international consensus about when of these modalities may be used or when diversion should be instituted. But in any case, both regimens include lifelong monitoring and frequent new interventions. Cost comparison of intra-detrusor injection of botulinum toxin versus augmentation cystoplasty for refractory neurogenic detrusor overactivity in childrenJournal of Pediatric UrologyVol. 18Issue 3PreviewTreatment options for refractory neurogenic detrusor overactivity (NDO) in children include botulinum toxin type A (BTX-A) and augmentation cystoplasty (AC). Although BTX-A is accepted in contemporary pediatric urologic practice, cost and long-term outcomes data for BTX-A are limited relative to the gold standard, AC. The purpose of this study was to compare the projected 10-year costs of AC versus BTX-A. Full-Text PDF