Botulinum toxin application in children with overactive and/or spastic detrusor – preliminary report
Article published in Urologia Polska 2008/61/4.

authors

Janusz Sulisławski, Wiesław Urbanowicz: Klinika Urologii Dziecięcej Collegium Medicum Uniwersytetu Jagiellońskiego

keywords

children neurogenic bladder detrusor overactivity botulinum toxin

summary

Introduction.
Neurogenic disorders of the urinary bladder in children are in most cases due to myelomeningocele. Standard therapy is

not effective in about 10% patients. These cases require surgical procedures such as urinary bladder augmentation. These procedures

are associated with surgical and metabolic complications.

The aim of the study.
This is a preliminary report of the use of botulinum toxin in children “resistant” to standard therapy with type

III neurogenic urinary bladder.

Material and methods.
Among 212 children with neurogenic bladder, classical therapy was not effective in 20 cases. All these

cases were children with type III neurogenic bladder. In these cases botulinum toxin A was injected into detrusor at 10-12 U/ kg b.w.

dose, but the total dose did not exceed 300 U. Therapeutic effects was assessed by cystometric investigations performed monthly

throughout a 9 month period. Moreover, control VCUG was executed after 3 months. T-test for relative variables was used for statistical

evaluation of the obtained parameters.

Conclusions.
Type A botulinum toxin is safe and do not provokes any side effects. Statistically, it results in the improvement of cystometric

investigation parameters. Temporary action of the BTx A present the limitation of this treatment method. Its use allows to

postpone the decision concerning extensive surgical procedure – urinary bladder augmentation in children.

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