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S22-15
(P)
INTRAVESICAL ABOBOTULINUMTOXINA IMPROVES URODYNAMIC PARAMETERS
IN CHILDREN WITH NEUROPATHIC BLADDER
Shehryer NAQVI
1
, Joanna CLOTHIER
2
, Arash TAGHIZADEH
1
, Kalpana PATIL
1
, Massimo GARRIBOLI
1
and Anne WRIGHT
2
1) Evelina London Children's Hospital, Paediatric Urology, London, UNITED KINGDOM - 2) Evelina London Children's
Hospital, Paediatric Renal and Bladder, London, UNITED KINGDOM
PURPOSE
There is limited published urodynamic data demonstrating the effect of intravesical abobotulinumtoxinA (Dysport
®
) in
children with neuropathic bladder overactivity. We investigated urodynamic outcomes in these children treated with
Dysport
®
and aimed to determine whether the effect is sustained over multiple administrations.
MATERIAL AND METHODS
A retrospective review of all children treated with intravesical Dysport
®
was performed (40iU/kg, max 1200iU). Data was
collected on Cystometric capacity (CC), compliance and maximum neurogenic detrusor overactivity (Max NDO) prior and
post injection. Patients were divided into two groups. Group 1 had only one injection and group 2 had multiple
injections. Results are presented as median (range).
RESULTS
Between July 2008 and July 2014 37 patients (19 boys) had a total of 73 intravesical Dysport
®
injections; age at
injection was 92 months (13-206). Fifteen patients had only one injection, 22 patients had 2 (2-5). The 2 groups were
homogeneous for age and underlying pathology. Significant improvement was observed in CC and max NDO.
Improvement in compliance did not reach significance (see table). Comparing the 2 groups, there was no difference in
CC (p=0.59), max NDO (p=1) or compliance (p=1).
Group 1
Group 2
pre
post
p
pre
post
p
CC (mL)
130 (12-375) 264 (20-550) <0.0002 131 (45-406) 245 (64-640) 0.02
max NDO (cmH2O)
47 (0-200)
0 (0-86)
0.003
43 (0-161)
0 (0-88)
0.002
Compliance (mL/cmH2O) 7.5 (1.5-29.5) 13.7 (1-151.5) 0.1
6.9 (0.27-105) 12.9 (2.6-128) 0.8
CONCLUSIONS
Intravesical Dysport
®
significantly increases CC and reduces max NDO in children with neuropathic bladder. The effect is
maintained over subsequent injections. Compliance is not significantly changed by Dysport
®
.