Intradetrusor Injections of Onabotulinum Toxin-A in Children With Urinary Incontinence due to Neurogenic Detrusor Overactivity Refractory to Antimuscarinic Treatment
Korean Journal of Urology
; : 281-287, 2014.
Article
em En
| WPRIM
| ID: wpr-76353
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE: This was a prospective single-arm study to assess the efficacy and safety of intradetrusor injections of onabotulinum toxin-A in children with urinary incontinence associated with neurogenic detrusor overactivity due to myelomeningocele. All patients had failed the first-line treatment of a combination of oral antimuscarinics and intermittent catheterization. MATERIALS AND METHODS: The study group consisted of 31 children with myelomeningocele with a mean age of 7.95 years (range, 5-3 years) who were followed up for a mean of 29 weeks. The amount of onabotulinum toxin A injected was 10 U/kg with a maximal dose of 300 U. There were 20 to 30 injection sites with rigid cystoscopic guidance under general anesthesia. RESULTS: Thirty of 31 patients reported dryness between intermittent catheterization intervals. The mean reduction in maximum detrusor pressure and the mean increase in maximum cystometric capacity from baseline were 53% and 51.5%, respectively, 6 weeks after injection. We found a 324% increase in mean bladder compliance and a 57% increase in mean intermittent catheterization volumes. The mean duration of efficacy was 28 weeks with a single injection and 36 weeks for repeated injections (minimum, 16 weeks; maximum, 52 weeks). The mean time interval between repeated onabotulinum toxin-A injections was 7 months (maximum, 13 months). Intradetrusor injections of onabotulinum toxin-A were well tolerated. CONCLUSIONS: Onabotulinum toxin-A injections into the bladder wall provide a significant symptomatic and urodynamic improvement in children with neurogenic detrusor overactivity due to myelomeningocele who are on intermittent catheterization. The treatment seems to be safe and very well tolerated.
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Texto completo:
1
Índice:
WPRIM
Assunto principal:
Incontinência Urinária
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Urodinâmica
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Bexiga Urinária
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Bexiga Urinaria Neurogênica
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Síndromes Mielodisplásicas
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Cateterismo
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Estudos Prospectivos
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Meningomielocele
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Antagonistas Muscarínicos
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Complacência (Medida de Distensibilidade)
Tipo de estudo:
Guideline
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Observational_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Korean Journal of Urology
Ano de publicação:
2014
Tipo de documento:
Article