Electromotive drug administration: a novel method for the treatment of overactive bladder with botulinum toxin a

Abstract

Purpose To compare the results of cystoscopic intradetrusor injection of Botulinum Toxin A (BTX-A) with Electromotive Drug Administration(EMDA) as a minimally less invasive method and evaluate the effects of these two treatment modalities on incontinence and urodynamic parameters. Material and methods This study is a randomized controlled trial that approved by ethical committee. We selected 20 eligible children with overactive bladder (refractory to CIC and anticholinergic medications) divided into two equal groups. Group I, received the BTX-A by EMDA. Following insertion of special catheter containing a spiral silver electrode, the bladder was drained with sterile water. The preferred instillation volume based on estimated cystometeric bladder capacity results in a spherical bladder configuration. Two electrode pads were placed at paraumbilical region using contact electrode gel. The current generator which connected to the electrodes produced a pulsed direct current with a frequency of 2,500 Hz. BTX-A was administered (10U/kg) to the maximum designated current intensity (15 mA) in 15 minutes.Group II, received conventional cystoscopic BTX-A injection under general anesthesia. Clinical and urodynamic assessments were performed before and after the procedure in both groups. Results Detailed results will be reported in our presentation. According to our data it seems that using BTX-A by EMDA, improved the urinary incontinence and urodynamic parameters with higher therapeutic duration, disseminated infusion and deeper layer penetration with no invasive procedures in comparison with intaravesical injection. Conclusions To the best of our knowledge, this is the first report of BTX-A application for the treatment of pediatrics overactive bladder by EMDA as a simple and safe method, and compare its trapeutic effects with intradetrusor injection.