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S21-10
(P)
200 I/U OF BOTULINUM TOXIN IS EFFECTIVE IN THE TREATMENT OF NON-
NEUROGENIC BLADDER OVERACTIVITY(OAB)
Chris KIMBER
1
, Janet CHASE
2
, Deborah RECHTMAN
2
, Juan BORTAGARAY
3
and Nathalie WEBB
3
1) Monash Childrens Hospital and Monash University, Paediatric Urology, Melbourne, AUSTRALIA - 2) Victorian Childrens
Continence Service, Malvern, AUSTRALIA - 3) Monash Children's Hospital, Paediatric Urology, Clayton, AUSTRALIA
PURPOSE
Optimum indications for and use of botulium toxin for childhood OAB remain unclear.This study reports results of
injection of 200i/u in 20 detrusor locations in children with OAB.
MATERIAL AND METHODS
98 children (8-16 years) were prospectively studied from 2011-2015.
All children underwent complex multidisciplary continence assessment including non-invasive urodynamics in all, and
selective video-urodynamics (n=10).
All children had documented treatment and results including , voiding/fluid retraining, bowel management,
anticholinegics and sacral TENS.
Indication for the procedure included severe and therapy resistant diurnal bladder overactivity ( n =73) , isolated giggle
incontinence ( n= 10), severe bladder pain and spasms ( n =5) and monosymptomatic enuresis ( n=10 ).
Following injection as described above, all children underwent clinical review, renal /bladder ultrasound and post void
residual measurement at 3-6 months.
RESULTS
Asymptomatic at 12-18/12 Additional medical therapy Second botox @ 9-12/12
DiurnalOAB ( 73)
49
32
35
Giggle(10)
8
0
3
Pain + spasms ( 5)
1
0
4
Noct enuresis ( 10)
4
6
6
Complications : urinary infection ( n= 3), increased PVR ( n=1), severe pain(n=2)
CONCLUSIONS
200 i/u of intravescial botulium toxin is safe for many non-neurogenic OAB. 63% require one treatment. Symptoms may
recur 9-12 months after injection and necessitate repeat therapy. Weight based dosage may not be required in children
over 8 yo.