• 作者：R.M. Romero ; ^{rromero.online@gmail.com} ; S. Rivas ; A. Parente ; M. Fanjul ; J.M. Angulo
• 关键词：Disfunci&oacute ; n vesical neur&oacute ; gena ; Disfunci&oacute ; n vesical no-neur&oacute ; gena ; Incontinencia urinaria ; Ampliaci&oacute ; n vesical ; Toxina botul&iacute ; nica
• 刊名：Actas Urol贸gicas Espa帽olas
• 出版年：2011
• 期刊代码：pca37_02104806
• 类别：med
• 出版时间：February 2011
• 卷：35
• 期：2
• 页码：89-92
• 文件大小：85 K

class="h4">Introduction

bladder dysfunction causes urinary incontinence and kidney damage in children. When treatment with anticholinergics and intermittent bladder catheterization fails, the alternative therapy is bladder augmentation.

class="h4">Patients and methods

between 2005 and 2009, a prospective study was carried out with Botox^庐 injected into the detrusor of children suffering from high-pressure bladder despite anticholinergic treatment. We assessed their urodynamic, clinical and radiological evolution prior to and at 4 weeks, 6 months and 1 year after the injection (10 u/kg of weight up to 300 u). Reinjection was indicated in the event of clinical or urodynamic worsening. We employed the Wilcoxom test to statistically analyze the urodynamic parameters.

class="h4">Results

12 patients were treated, 11 with neurogenic bladder (91.7%) and 1 with posterior urethral valves (8.4%). The mean age was 12.6 (4.3-17.8) years and follow-up took place after 40.8 (16.9-45-7) months. Bladder capacity, detrusor accommodation and pressure improved after 4 weeks in all the patients except in 2 (16.7%). This improvement decreased after 6 months, although successive injections produced similar changes. One patient (8.3%) received 1 dose, six (50%) two doses and five (41.7%) received three. Clinical and urodynamic improvement in 8 patients (66.7%) prevented bladder augmentation.

class="h4">Conclusions

repeated botulinum toxin injection in the detrusor is a therapeutic instrument for high pressure and low accommodation bladders in children. It could replace bladder augmentation in some cases, however further studies with long-term follow-up care are required to appropriately evaluate its safety and effectiveness.