Urodynamic Outcomes in Children after Single and Multiple Injections for Overactive and Low Compliance Neurogenic Bladder Treated with Abobotulinum Toxin A

No AccessJournal of UrologyPediatric Urology1 Feb 2020Urodynamic Outcomes in Children after Single and Multiple Injections for Overactive and Low Compliance Neurogenic Bladder Treated with Abobotulinum Toxin A Shehryer Naqvi, Joanna Clothier, Anne Wright, and Massimo Garriboli Shehryer NaqviShehryer Naqvi Evelina London Childrens Hospital, London, United Kingdom More articles by this author , Joanna ClothierJoanna Clothier Evelina London Childrens Hospital, London, United Kingdom More articles by this author , Anne WrightAnne Wright Evelina London Childrens Hospital, London, United Kingdom More articles by this author , and Massimo GarriboliMassimo Garriboli *Correspondence: E-mail Address: [email protected]. Evelina London Childrens Hospital, London, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000540AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Intradetrusor botulinum toxin is an established part of the treatment pathway for pediatric patients with neurogenic bladder. We determined the urodynamic effect of single and multiple administrations of abobotulinum toxin A in pediatric patients with neurogenic bladder, and determined the urodynamic efficacy of abobotulinum toxin A in low compliance vs overactive bladders. Materials and Methods: We conducted a single center retrospective review of all pediatric patients with neurogenic bladder treated with abobotulinum toxin A. Videourodynamic data on cystometric capacity, maximum neurogenic detrusor overactivity pressure and compliance were gathered before and after the first abobotulinum toxin A administration and after the last administration. Patients were divided into low compliance and overactive bladder groups depending on initial videourodynamics findings. Paired t-test was used to compare videourodynamic outcomes before vs after abobotulinum toxin A injection. The Mann-Whitney U test was used to compare bladder groups. Results: A total of 30 patients were included in the study. Of these patients 15 (50%) received multiple abobotulinum toxin A injections. There were 16 patients (53%) with overactive bladder. Abobotulinum toxin A administration significantly improved cystometric capacity (p <0.0001) and maximum neurogenic detrusor overactivity (p=0.0001). Overall, compliance did not change significantly (p=0.25). There was no significant difference in urodynamic parameters between first and last abobotulinum toxin A injections. Improvement in cystometric capacity (p=0.05) and maximum neurogenic detrusor overactivity (p=0.25) was similar between the low compliance and overactive bladder groups. Compliance significantly improved in the low compliance group vs the overactive bladder group (p=0.016). Conclusions: Intradetrusor abobotulinum toxin A improves cystometric capacity and maximum neurogenic detrusor overactivity in pediatric patients with neurogenic bladder. This effect is maintained over multiple injections. Compliance is significantly improved in patients with low compliance bladder vs overactive bladder. References 1. : Effects of botulinum toxin type A in the bladder wall of children with neurogenic bladder dysfunction: a comparison of histological features before and after injections. J Urol 2011; 185: 2552. 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See Editorial on page 263. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue 2February 2020Page: 413-419 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsneurogenicurodynamicsurinary bladderabobotulinumtoxinAMetricsAuthor Information Shehryer Naqvi Evelina London Childrens Hospital, London, United Kingdom More articles by this author Joanna Clothier Evelina London Childrens Hospital, London, United Kingdom More articles by this author Anne Wright Evelina London Childrens Hospital, London, United Kingdom More articles by this author Massimo Garriboli Evelina London Childrens Hospital, London, United Kingdom *Correspondence: E-mail Address: [email protected]. More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. See Editorial on page 263. Advertisement Loading ...