title: Botulinum toxin-A (Botox) intradetrusor injections in children with neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic literature review.
abstract: OBJECTIVE
  Describe and discuss the efficacy and safety of botulinum toxin type A (BTX-A) intradetrusor injections in children with neurogenic detrusor overactivity (NDO) and urinary incontinence or overactive bladder symptoms of neurogenic origin (NOAB).
  
  
  METHODS
  A MEDLINE and EMBASE search for clinical studies involving BTX-A injected into the detrusor of children with NDO or NOAB was performed, prior to data analysis.
  
  
  RESULTS
  A total of six articles evaluating the efficacy and safety of Botox in patients with NDO and incontinence/NOAB were selected. The underlying neurological disease was myelomeningocele in 93% of patients. Most were over 2 years of age. The most common amount of Botox injected was 10-12 U/kg with a maximal dose of 300 U, usually as 30 injections of 10 U/ml in the bladder (excluding the trigone) under cystoscopic guidance and general anaesthesia. Most of the studies reported a significant improvement in clinical (65-87% became completely dry) as well as urodynamic (in most studies mean maximum detrusor pressure was reduced to <40 cm H(2)O and compliance was increased >20 ml/cm H(2)O) variables, without major adverse events.
  
  
  CONCLUSIONS
  Botox injections into the detrusor provide a clinically significant improvement and seem to be very well tolerated in children with NDO and incontinence/NOAB refractory to antimuscarinics.
authors.affiliation: Hôpital Rangueil, Toulouse, France. xaviergame@hotmail.com
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
authors.forename: Pascal
authors.initials: P
authors.lastname: Mouracade
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chartier-Kastler
authors.forename: Elke
authors.initials: E
authors.lastname: Viehweger
authors.forename: Raphael
authors.initials: R
authors.lastname: Moog
authors.forename: Gérard
authors.initials: G
authors.lastname: Amarenco
authors.forename: Pierre
authors.initials: P
authors.lastname: Denys
authors.forename: Marianne
authors.initials: M
authors.lastname: De Seze
authors.forename: François
authors.initials: F
authors.lastname: Haab
authors.forename: Gilles
authors.initials: G
authors.lastname: Karsenty
authors.forename: Jacques
authors.initials: J
authors.lastname: Kerdraon
authors.forename: Brigitte
authors.initials: B
authors.lastname: Perrouin-Verbe
authors.forename: Alain
authors.initials: A
authors.lastname: Ruffion
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Soler
authors.forename: Christian
authors.initials: C
authors.lastname: Saussine
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A