Botulinum toxin--a new therapeutic agent in girls with non-neurogenic overactive bladder--a case report and review of the literature.

The aim of this article is to present the safety and efficacy of intradetrusor botulinum toxin injections in the treatment of non-neurogenic overactive bladder in pediatric patients. The electronic database MEDLINE (1966-2009) was searched including the following entries: non-neurogenic overactive bladder and botulinum overactive bladder. Data on the investigation topic are scarce. Most of the papers concern neurogenic overactive bladder in adults, with only a few dealing with children with neurological disturbances. Therefore, the following paper presents a case of botulin toxin treatment in girl with overactive bladder. The patient did not tolerate the standard anticholinergic therapy and did not present neurollogical disturbances. Successful outcome allows us to state that intradetrusor botulinum toxin type A injection is a promising new treatment method in the refractory cases of non-neurogenic pediatric overactive bladder.

[Urodynamic disturbances among children with vesico-ureteral reflux (VUR)]. / Odchylenia w badaniach urodynamicznych u dzieci z odplywem pecherzowo-moczowodowym (OPM).

UNLABELLED: Lower urinary tract dysfunction plays significant role in patogenesis of vesicoureteral reflux (VUR). Thus, urodynamic assessment is very useful in diagnosis and treatment of VUR. AIM: Assessment of the incidence of urodynamic disturbances among children with VUR. MATERIAL AND METHODS: Retrospective assessment of 125 children with VUR including 93 assessed urodymically. RESULTS: Urodynamic disturbances were found in 58 patients (70.9% of examined children), of which--detrussor hyperactivity in 25 (43.1% of children with urodynamic disturbances), detrussor hyperactivity with subvesical obstruction or dysfunctional voiding in 6 (10.3%), dysfunctional voiding in 17 (29.3%), anatomical subvesical obstruction in 9 (15.5%), detrussor hypotony in 1 (1.7%). No disturbances were found in 27 (29.1% of examined children). Children with detrussor overactivity were the prevalent group among all children with lower urinary tract dysfunction. CONCLUSIONS: Children with lower urinary tract dysfunction constitute a significant part of children with VUR.

Recurrent urinary tract infections--uropathogen incidence and drug sensitivity.

The aim of the study was the retrospective analysis of the results of the drug sensitivity studies of bacterial species cultured from 681 urinary specimens collected from 79 children (12 boys and 67 girls) aged 0-18 years with recurrent urinary tract infection in a period from 1997 to 2001. Factors predisposing to recurrent urinary tract infections and the incidences of particular uropathogens were also analyzed. Escherichia coli (57.3%), Proteus spp. (15.6%) and Pseudomonas aeruginosa (9.1%) were the most frequent isolated pathogens. Reinfections and relapses of urinary tract infections were observed in 74.7% and 25.3% of the children, respectively. In some children etiologic variability of particular infection episodes were observed. In the majority of the children infection episodes were caused by one or two bacterial species and new infections differed from previous ones only in drug sensitivity. In 30 children vesicoureteral reflux was detected. Other anatomical abnormalities of urinary tract were revealed in 17 children. In 18 children, neurogenic bladder dysfunction was diagnosed. Urodynamics disclosed functional abnormalities in 48/55 children.

Dysfunctional voiding and urodynamic disorders in children with recurrent urinary tract infection.

The purpose of the study was to determine: a) the incidence of particular symptoms of dysfunctional voiding, b) the incidence of particular urodynamic disorders, and c) urodynamic patterns typical of particular symptoms of dysfunctional voiding in children with recurrent urinary tract infection. The study comprised 282 children with recurrent urinary tract infection. In order to diagnose functional disturbances of the lower urinary tract, such as detrusor instability, detrusor-sphincter dyscoordination, detrusor instability associated with detrusor-sphincter dyscoordination, and functional subvesical obstruction, in all children, urodynamic examination was performed. For each symptom of dysfunctional voiding (nocturnal enuresis, diurnal urinary incontinence, urinary urgency, and voiding postponement syndrome) urodynamic pattern was determined. The study revealed that functional disturbances of the lower urinary tract coexist with positive histories of micturition disturbances. In the studied children, detrusor instability was the most common urodynamic disorder. Nocturnal enuresis, diurnal urinary incontinence and urinary urgency were symptoms of dysfunctional voiding typical of detrusor stability. In children with and without vesico-ureteral reflux, the incidences of particular urodynamic disorders were similar. This seems to suggest that disturbances of the lower urinary tract may be secondary to infection.