دورية أكاديمية
Intravesical botulinum-A toxin in children with refractory non-neurogenic overactive bladder.
| العنوان: | Intravesical botulinum-A toxin in children with refractory non-neurogenic overactive bladder. |
|---|---|
| المؤلفون: | Lambregts AP; Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands., Nieuwhof-Leppink AJ; Department of Medical Pscychology, Urotherapy and Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, the Netherlands. Electronic address: a.nieuwhof@umcutrecht.nl., Klijn AJ; Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands., Schroeder RPJ; Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. |
| المصدر: | Journal of pediatric urology [J Pediatr Urol] 2022 Jun; Vol. 18 (3), pp. 351.e1-351.e8. Date of Electronic Publication: 2022 Feb 18. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 101233150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4898 (Electronic) Linking ISSN: 14775131 NLM ISO Abbreviation: J Pediatr Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Kidlington, Oxford, UK : Elsevier, c2005- |
| مواضيع طبية MeSH: | Botulinum Toxins, Type A* , Neuromuscular Agents* , Urinary Bladder, Neurogenic*/complications , Urinary Bladder, Overactive*/complications , Urinary Bladder, Overactive*/drug therapy , Urinary Incontinence*/etiology, Child ; Humans ; Male ; Quality of Life ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Introduction: Overactive bladder (OAB) with urinary incontinence poses a potentially significant impact on daily activities and quality of life. OAB can be unresponsive to specific urotherapy and antispasmodic medication. Due to its successful outcomes in the treatment of neurogenic bladder, intravesical botulinum-A toxin (BTX-A) became a possible solution for children refractory to treatment. Objective: To analyse the outcomes of intravesical BTX-A injections on bladder volume and incontinence in children with refractory OAB. Study Design: The charts of children diagnosed with refractory non-neurogenic OAB who underwent BTX-A treatment in our centre since 2011 were retrospectively analysed. The functional bladder volume (FBV) is expressed as a percentage of the expected bladder capacity (EBC) for age. Dependent variables were compared using the Wilcoxon Signed Rank test. A multivariate logistic regression was used to identify predictors of the response on urinary incontinence. Results: Fifty children (41 boys) with a median age of 9.9 years were included. In the short term, there was a significant increase in FBV after initial BTX-A treatment from a median of 52.9%-70% (p = 0.000). In the short (<6 months) and long term (6-12 months) 72% and 46% showed improvement of continence, respectively. Male gender and small baseline FBV predict a positive outcome on continence in the long term. The most prevalent complications were urinary tract infections occurring in five cases (10%). Discussion: Although BTX-A injections serve as an effective therapy to increase bladder volume in non-neurogenic OAB children, the outcomes on urinary incontinence are highly variable. This may be a consequence of the multifactorial aspects of this condition. BTX-A will enable children to inhibit their bladder urgency. The effectiveness of post-BTX-A urotherapy training will therefore most probably be higher. We believe that BTX-A injections should be reserved for children refractory to both specific urotherapy and medication. An appropriate population seems to be children with severe OAB symptoms, confirmed detrusor overactivity in urodynamic study and reduced bladder volume. Conclusion: In refractory OAB children, BTX-A injections are safe and effective in enlarging bladder volume and reducing OAB symptoms, particularly in the first six months after injection. Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Botulinum toxins; Overactive bladder; Pediatrics; Refractory incontinence; Type A; Urinary incontinence; Urotherapy |
| المشرفين على المادة: | 0 (Neuromuscular Agents) EC 3.4.24.69 (Botulinum Toxins, Type A) |
| تواريخ الأحداث: | Date Created: 20220314 Date Completed: 20220628 Latest Revision: 20220712 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jpurol.2022.02.007 |
| PMID: | 35283021 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1873-4898 |
|---|---|
| DOI: | 10.1016/j.jpurol.2022.02.007 |