- 作者：Xavier Gamé ; Pascal Mouracade ; Emmanuel Chartier-Kastler ; Elke Viehweger ; Raphael Moog ; Gé ; rard Amarenco ; Pierre Denys ; Marianne De Seze ; Franç ; ois Haab ; Gilles Karsenty ; Jacques Kerdraon ; Brigitte Perrouin-Verbe ; Alain Ruffion ; Jean-Marc Soler ; Christian Saussine
- 关键词：Botulinum toxin A ; Overactive bladder ; Neurogenic ; Urinary incontinence ; Urodynamics ; Children
- 刊名：Journal of Pediatric Urology
- 出版年：2009
- 出版时间：June 2009
- 年：2009
- 卷：5
- 期：3
- 页码：156-164
- 全文大小：180 K
ObjectivesDescribe and discuss the efficacy and safety of botulinum toxin type A (BTX-A) intradetrusor injections in children with neurogenic detrusor overactivity (NDO) and urinary incontinence or overactive bladder symptoms of neurogenic origin (NOAB).Methods
A MEDLINE and EMBASE search for clinical studies involving BTX-A injected into the detrusor of children with NDO or NOAB was performed, prior to data analysis.
Results
A total of six articles evaluating the efficacy and safety of Botox® in patients with NDO and incontinence/NOAB were selected. The underlying neurological disease was myelomeningocele in 93 % of patients. Most were over 2 years of age. The most common amount of Botox injected was 10–12 U/kg with a maximal dose of 300 U, usually as 30 injections of 10 U/ml in the bladder (excluding the trigone) under cystoscopic guidance and general anaesthesia. Most of the studies reported a significant improvement in clinical (65–87 % became completely dry) as well as urodynamic (in most studies mean maximum detrusor pressure was reduced to <40 cm H2O and compliance was increased >20 ml/cm H2O) variables, without major adverse events.
Conclusions
Botox injections into the detrusor provide a clinically significant improvement and seem to be very well tolerated in children with NDO and incontinence/NOAB refractory to antimuscarinics.