Abstract | AIMS: METHODS: We retrospectively reviewed the charts of 11 children (mean age 6.7 ± 5.3 years) with neuropathic bladder and poor bladder compliance (mean 7 ml/cmH(2) O) treated with intradetrusor injection of BoNT/A. After urodynamic evaluation a standardized injection was performed. The authors describe their results in 11 children after the first (5×) or repeated (6×) BoNT/A injections. Re-evaluation was performed 3 and 12 months after each injection. RESULTS: Three months after injection detrusor pressure decreased by 17% and bladder capacity increased by 33%. In all but 1 patient bladder compliance stayed poor. Twelve months after treatment patients still had an effect but the values were already reverting towards preoperative levels. With repeated injections we achieved a similar effect on capacity and detrusor pressure as after the first injection. Overall, bladder compliance normalized (>20 cmH(2) O) in only 1 patient. CONCLUSIONS: The results confirmed the positive temporary effect of BoNT/A on detrusor pressure and bladder capacity in children with myelomeningocele, even after repeated injections. Nevertheless, bladder compliance stayed severely pathological. Whether an earlier treatment may prevent poor bladder compliance is a yet unanswered question.
|
Authors | Maya Horst, Daniel M Weber, Christine Bodmer, Rita Gobet |
Journal | Neurourology and urodynamics
(Neurourol Urodyn)
Vol. 30
Issue 8
Pg. 1546-9
(Nov 2011)
ISSN: 1520-6777 [Electronic] United States |
PMID | 21674597
(Publication Type: Journal Article)
|
Copyright | Copyright © 2011 Wiley Periodicals, Inc. |
Chemical References |
- Neuromuscular Agents
- Botulinum Toxins, Type A
- incobotulinumtoxinA
|
Topics |
- Administration, Intravesical
- Adolescent
- Age Factors
- Botulinum Toxins, Type A
(administration & dosage, adverse effects)
- Child
- Child, Preschool
- Compliance
- Drug Administration Schedule
- Female
- Humans
- Infant
- Male
- Meningomyelocele
(complications, physiopathology)
- Neuromuscular Agents
(administration & dosage, adverse effects)
- Pressure
- Retrospective Studies
- Switzerland
- Time Factors
- Treatment Outcome
- Urinary Bladder
(drug effects, innervation, physiopathology)
- Urinary Bladder, Neurogenic
(drug therapy, etiology, physiopathology)
- Urodynamics
(drug effects)
|