Abstract | OBJECTIVES: METHODS: In a prospective study, 26 children with myelomeningocele (20 boys and 6 girls, mean age 6.9 years) were included. All patients had been nonresponders to medical treatment and required clean intermittent catheterization. Under cystoscopic guidance, 10 IU/kg of botulinum toxin A was injected into the detrusor muscle, sparing the trigone and ureteral orifices. In each patient, urinary incontinence grade and improvement in parameters of interest in the evaluation of bowel dysfunction were assessed before and 4 months after injection. Conventional urodynamic studies to determine maximal bladder capacity and maximal detrusor pressure and voiding cystoureterography were also performed. RESULTS: Four months after procedure, 19 patients (73%) had become completely dry between clean intermittent catheterizations, and the total improvement in urine incontinence was 88%. The mean maximal detrusor pressure was decreased to 83.2 +/- 4.6 cm H2O from the baseline of 139.3 +/- 11.2 (P <0.01). The average maximal bladder capacity increased from 102.8 +/- 6.3 mL to 270.2 +/- 9.5 mL (P <0.01). Of the 15 patients who had varying degrees of vesicoureteral reflux before the procedure, 11 (73%) had decrease in the vesicoureteral reflux grade. Also, bowel dysfunction improved in 10 (66%) of the 15 patients. CONCLUSIONS:
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Authors | Abdol-Mohammad Kajbafzadeh, Shahram Moosavi, Parvin Tajik, Hamid Arshadi, Seyedmehdi Payabvash, Amirali H Salmasi, Hamid R Akbari, Farideh Nejat |
Journal | Urology
(Urology)
Vol. 68
Issue 5
Pg. 1091-6; discussion 1096-7
(Nov 2006)
ISSN: 1527-9995 [Electronic] United States |
PMID | 17113899
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
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Topics |
- Administration, Intravesical
- Adolescent
- Botulinum Toxins, Type A
(administration & dosage)
- Child
- Child, Preschool
- Fecal Incontinence
(drug therapy, etiology)
- Female
- Humans
- Male
- Meningomyelocele
(complications)
- Prospective Studies
- Urinary Bladder, Neurogenic
(drug therapy, etiology)
- Urinary Incontinence
(drug therapy, etiology)
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