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Urinary incontinence in children: botulinum toxin is a safe and effective treatment option

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Abstract

Purpose

This study’s aim was to assess the use of intravesical injection of botulinum neurotoxin type A (BoNT-A) as a treatment of overactive bladder (OAB) in children.

Methods

A 6-year retrospective study of children who received BoNT-A for OAB was performed. Treatment outcome was classified as complete success (CS), partial success (PS) or treatment failure (TF).

Results

Of the 57 patients who received BoNT-A treatment for OAB, 35 were males. CS occurred in 74.2% of males and 54.5% of females. PS was achieved in 20% of males and 18.2% of females. TF occurred in 2.9% of males and 22.7% of females. Anticholinergics had previously been used and had been effective in 58.6% and 83.3% of males and females. Significant side effects to medications were experienced in 12 (41.4%) males and 4 (22.2%) females. Of these, BoNT-A achieved CS in seven (53.3%) males and two (50%) females and PS in three (25%) males and one (25%) female. BoNT-A was successful in seven (58.3%) males and two (66.7%) females where anticholinergics were ineffective.

Conclusions

BoNT-A has a role in a carefully selected subgroup of children with overactive bladder symptoms including those with medication side effects and treatment compliance issues. It may have a role in patients who do not respond to conventional therapy.

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References

  1. Erbguth FJ (2008) From poison to remedy: the chequered history of botulinum toxin. J Neural Transm 115(4):559–565

    Article  PubMed  CAS  Google Scholar 

  2. Lim EC, Seet RC (2007) Botulinum toxin, Quo Vadis? Med Hypotheses 69(4):718–723

    Article  PubMed  CAS  Google Scholar 

  3. Schurch B, Schmid DM, Stohrer M (2000) Treatment of neurogenic incontinence with botulinum toxin A. N Engl J Med 342(9):665

    Article  PubMed  CAS  Google Scholar 

  4. Schurch B (2006) Botulinum toxin for the management of bladder dysfunction. Drugs 66(10):1301–1318

    Article  PubMed  CAS  Google Scholar 

  5. Aoki KR (2003) Pharmacology and immunology of botulinum toxin type A. Clin Dermatol 21(6):476–480

    Article  PubMed  Google Scholar 

  6. Dressler D, Benecke R (2007) Pharmacology of therapeutic botulinum toxin preparations. Disabil Rehabil 29(23):1761–1768

    Article  PubMed  Google Scholar 

  7. Apostolidis A, Dasgupta P, Fowler CJ (2006) Proposed mechanism for the efficacy of injected botulinum toxin in the treatment of human detrusor overactivity. Eur Urol 49(4):644–650

    Article  PubMed  CAS  Google Scholar 

  8. Duthie J et al (2007) Botulinum toxin injections for adults with overactive bladder syndrome. Cochrane Database Syst Rev 3:CD005493

    PubMed  Google Scholar 

  9. Anger JT et al (2010) Outcomes of intravesical botulinum toxin for idiopathic overactive bladder symptoms: a systematic review of the literature. J Urol 183(6):2258–2264

    Article  PubMed  Google Scholar 

  10. De Ridder D (2008) Botulinum toxin: future developments. BJU Int 102(Suppl 1):20–22

    Article  PubMed  Google Scholar 

  11. Hoebeke P et al (2006) The effect of botulinum-A toxin in incontinent children with therapy resistant overactive detrusor. J Urol 176(1):328–330 (discussion 331)

    Article  PubMed  CAS  Google Scholar 

  12. Marte A et al (2010) Effectiveness of botulinum-A toxin for the treatment of refractory overactive bladder in children. Eur J Pediatr Surg 20(3):153–157

    Article  PubMed  CAS  Google Scholar 

  13. Koff SA (1983) Estimating bladder capacity in children. Urology 21(3):248

    Article  PubMed  CAS  Google Scholar 

  14. Akbar M et al (2007) Repeated botulinum-A toxin injections in the treatment of myelodysplastic children and patients with spinal cord injuries with neurogenic bladder dysfunction. BJU Int 100(3):639–645

    Article  PubMed  Google Scholar 

  15. Schulte-Baukloh H et al (2003) Botulinum-a toxin detrusor injection as a novel approach in the treatment of bladder spasticity in children with neurogenic bladder. Eur Urol 44(1):139–143

    Article  PubMed  CAS  Google Scholar 

  16. Makovey I et al. (2011) Botulinum toxin outcomes for idiopathic overactive bladder stratified by indication: Lack of anticholinergic efficacy versus intolerability. Neurourol Urodyn. doi:10.1002/nau.21150 (Epub ahead of print)

  17. Altaweel W et al (2006) Repeated intradetrusor botulinum toxin type A in children with neurogenic bladder due to myelomeningocele. J Urol 175(3 Pt 1):1102–1105

    Article  PubMed  CAS  Google Scholar 

  18. Riccabona M et al (2004) Botulinum-A toxin injection into the detrusor: a safe alternative in the treatment of children with myelomeningocele with detrusor hyperreflexia. J Urol 171(2 Pt 1):845–848 discussion 848

    Article  PubMed  CAS  Google Scholar 

  19. Kajbafzadeh AM et al (2010) Antibody formation following botulinum toxin type A (Dysport) injection in children with intractable bladder hyper-reflexia. Urology 76(1):233–237

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest and no funding was received for this project.

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Authors and Affiliations

  1. Department of Paediatric Urology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, Ireland

    Dermot Thomas McDowell, Farhan Tareen & Feargal Quinn

  2. Department of Paediatric Nephrology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, Ireland

    Damien Noone & Mary Waldron

Authors
  1. Dermot Thomas McDowell
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  2. Damien Noone
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  3. Farhan Tareen
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  4. Mary Waldron
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  5. Feargal Quinn
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Corresponding author

Correspondence to Feargal Quinn.

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McDowell, D.T., Noone, D., Tareen, F. et al. Urinary incontinence in children: botulinum toxin is a safe and effective treatment option. Pediatr Surg Int 28, 315–320 (2012). https://doi.org/10.1007/s00383-011-3039-5

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  • DOI: https://doi.org/10.1007/s00383-011-3039-5

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