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13:54 - 14:00
ICCS S5-7
(LO)
EFICACY OF INTRADETRUSOR INJECTION OF ONABOTULINUMTOXIN A IN
PEDIATRIC POPULATION
Marco SOBRON, Esteban EMILIANI, Clara CENTENO, Anna BUJONS, Jorge CAFFARATTI and Humberto VILLAVICENCIO
Fundacio Puigvert, Pediatric Urology, Barcelona, SPAIN
PURPOSE
The aim of the study is to evaluate the efficacy of onabotulinumtoxinA for the treatment of neurogenic and idiopathic
overactive bladder resistant to medical treatment in pediatric population.
MATERIAL AND METHODS
We retrospectively reviewed the clinical records of 20 pediatric patients diagnosed of neurogenic and idiopathic
overactive bladder by urodynamic test resistant to antimuscarinics and treated with intradetrusor injection of
onabotulinumtoxinA (100-300UI). Demographics, response duration, subjective and urodynamic efficacy were assessed
at two and twelve months after surgery.
RESULTS
20 patients were reviewed, with a median age of 11 years (6-18 years). 67% had neurogenic overactive bladder and
33% idiopathic. 53% preformed clean intermittent catheterization (CIC) before treatment. All patients referred clinical
improvement of symptoms after the first onabotulinumtoxinA injection, 46.7% were completely dry. In patients with
idiopathic overactive bladder 80% were dry and 20% had urine leakage. In neurogenic patients 40% were dry and 60%
persisted with incontinence. 6 patients required a second injection and one patient a third one. The median time for a
second or third injection was of 419 days (203-784). The urodynamic test revealed an upgrade on the bladder capacity
of a median of 52 cc and a median reduction of the peak detrusor pressure of 27,9 cm de H2O, median bladder
compliance was upgraded in 9,4 ml/cm H2O. Only one patient had acute urinary retention that required CIC for a
month.
CONCLUSIONS
Treatment of neurogenic and idiopathic overactive bladder with onabotulinumtoxin A was effective and safe improving
children's quality of life ameliorating urodynamic parameters