Ces Urol 2009, 13(3):207-210 | DOI: 10.48095/cccu2009014
Initial experience with intradetrusor application of botulinum A toxin in children with detrusor overactivity
- Urologické oddělení Kliniky dětské chirurgie, ortopedie a traumatologie FN Brno
Objective: Publication of initial experience gained from mini-invasive treatment of children?s bladder overactivity by an intradetrusor application of botulinum A toxin.
Material and method: During 2007/2008, 6 children at the age from 5 to 12 years were treated by endoscopic application of botulinum A toxin into detrusor; an application of this method has always followed, when the conservative treatment failed. In two cases, the urinary detrusor hyperactivity was neurogenic; the other four patients have non-neurogenic origin of overactivity. The botulinum A toxin in a dose of 10 IU/kg complying with the children body weight was applied into 25 or 30 detrusor points. Upon the subsequent evaluation, continence effect, urodynamic parameters and duration effect were considered.
Results: 5 patients have shown an improvement of urinary continence. An enlargement of bladder capacity by 84 % on the average was reached with all patients. In case of the 5 children, the intravesical pressure and non-inhibited contractions were reduced by 52% on the average. A maximum of improvement has appeared 3 months after the botulinumtoxin application, whereas lower values were recorded 6 or 9 months later.
Conclusion: An application of botulinum A toxin represents a safe alternative treatment for children suffering from detrusor hyperactivity, caused by neurogenic or non-neurogenic genesis. A direct intra-detrusor-application of botulinum A toxin means a distinct decrease of the non-inhibited contractions, reduction of the intravesical pressure, increase of the bladder capacity and improving of the urirary continence.
Keywords: neurogenic bladder, botulinum A toxin, detrusor overactivity, incontinence
Received: April 11, 2009; Accepted: May 11, 2009; Published: June 1, 2009
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