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Urodynamic assessment of children treated with botulinum toxin A injections for urge incontinence: a pilot study.

AbstractOBJECTIVE:
This study aimed to investigate changes in urodynamic findings and symptoms after detrusor injections of botulinum toxin A (BTX-A) in children with idiopathic detrusor overactivity (IDO) and urge incontinence.
MATERIAL AND METHODS:
Eight girls and five boys, aged 7-19 years, who had urge incontinence refractory to scheduled voiding and anticholinergics, were included this prospective study. Urodynamic studies showed postoperative IDO in 12 patients. A dose of 50-100 IU (1.3 -- 4.8 IU/kg) BTX-A was primarily administered at 15-20 detrusor sites. A control urodynamic study was performed within 3 months after the injections. Seven patients had a repeated procedure 16 (range 6-24) months on the average after the first one.
RESULTS:
Eleven of the 13 patients had daily incontinence and two had incontinence a couple of times a week in association with urge symptoms. Postoperatively, no patient had urinary retention, but one girl had a urinary tract infection 4 months after the therapy. Five patients had a full response, seven partial responses and one no response 1-3 months after the first treatment. After 1 year, three of nine patients still have full response. Maximum cystometric capacity increased after the first treatment from a median of 227 ml to 379 ml (p = 0.005) and the number of patients with uninhibited detrusor contractions more than 30 cmH₂O during the filling phase decreased from eight to two out of 13 (p = 0.041).
CONCLUSIONS:
Intradetrusor BTX-A injections effectively reduce day-time wetting, significantly increase bladder volume and decrease detrusor overactivity in children with urge incontinence refractory to scheduled voidings and anticholinergics.
AuthorsT T Lahdes-Vasama, A Anttila, E Wahl, S Taskinen
JournalScandinavian journal of urology and nephrology (Scand J Urol Nephrol) Vol. 45 Issue 6 Pg. 397-400 (Dec 2011) ISSN: 1651-2065 [Electronic] England
PMID21740110 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
Topics
  • Adolescent
  • Adult
  • Botulinum Toxins, Type A (administration & dosage, therapeutic use)
  • Child
  • Female
  • Humans
  • Injections, Intramuscular
  • Male
  • Neuromuscular Agents (administration & dosage, therapeutic use)
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome
  • Urinary Bladder, Overactive (drug therapy)
  • Urinary Incontinence, Urge (drug therapy)
  • Urodynamics (drug effects)
  • Young Adult

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