Vol 55: Intradetrusor Injections of Onabotulinum Toxin-A in Children With Urinary Incontinence due to Neurogenic Detrusor Overactivity Refractory to Antimuscarinic Treatment.Reportar como inadecuado



 Vol 55: Intradetrusor Injections of Onabotulinum Toxin-A in Children With Urinary Incontinence due to Neurogenic Detrusor Overactivity Refractory to Antimuscarinic Treatment.


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This article is from Korean Journal of Urology, volume 55.AbstractPurpose: 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.



Autor: Tarcan, Tufan; Akbal, Cem; Sekerci, Cagri A.; Top, Tuncay; Simsek, Ferruh

Fuente: https://archive.org/







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