title: Botulinum toxin type A for neurogenic detrusor overactivity due to spinal cord lesions in children: a retrospective study of seven cases.
abstract: OBJECTIVE
  To assess the effectiveness and safety of intradetrusor injections of botulinum toxin type A (BTA) used to treat neurogenic detrusor overactivity in children.
  
  
  METHODS
  We retrospectively reviewed the records of seven children treated at least once (7/7: one injection; 4/7: two and three injections; 2/7: four injections; 1/7: five injections) with intradetrusor BTA injections in 2005-2008, for neurogenic detrusor overactivity with incontinence despite timed bladder catheterizations and anticholinergic agents. Clinical, urodynamic, and imaging study data at baseline were collected. Clinical efficacy criteria were the urinary tract infection (UTI) rate, continence, and need for anticholinergic agents. The following urodynamic data were assessed: maximum catheterized volume without leakage, reflex volume, maximum detrusor pressure, and bladder compliance.
  
  
  RESULTS
  Seven children received 18 injections. Social continence was achieved from the first injection. No further recurrent lower UTIs occurred. Maximum catheterized volume and reflex volume increased, and maximum detrusor pressure decreased. Detrusor compliance became interpretable and increased. Grade II right vesicoureteral reflux, present at baseline in one patient, resolved after BTA therapy. UTIs were the only adverse effects.
  
  
  CONCLUSIONS
  Injection with BTA proved effective and safe in the short term. This may be an alternative to surgery in children with neurogenic detrusor overactivity.
authors: Unité pédiatrique de Médecine Physique et Réadaptation - Groupe Hospitalier Universitaire Trousseau - La Roche Guyon, Université Pierre et Marie Curie, Paris, France. claire.dongocthanh.razazi@gmail.com
authors: C
authors: C
authors: Do Ngoc Thanh
authors: G
authors: G
authors: Audry
authors: V
authors: V
authors: Forin
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000209:etiology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000209:etiology
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A