title: Intravesical botulinum type-A toxin (Dysport®) in the treatment of idiopathic detrusor overactivity in children.
abstract: OBJECTIVE
  Botulinum type-A toxin is increasingly used for refractory idiopathic detrusor overactivity (IDO) in children. We reviewed our experience and sought to ascertain the influence of dose and functional bladder capacity on outcome.
  
  
  METHODS
  Thirty patients, aged 6-16 years, with urodynamically proven IDO, had intravesical injections of 400-500 iu of Dysport(®). Outcome was assessed clinically at least 5 months after the injection.
  
  
  RESULTS
  Data were available for 27 patients. Urinary frequency was improved in 10; nocturia was improved in 7. Urgency resolved in 10 patients and urge incontinence in 12 (44%). Complications reported were UTI (7), urinary retention (1) and bladder pain (1). The dose of Dysport(®) used was not significantly higher (14 iu/kg v 13 iu/kg) in patients dry at follow up than in those who remained wet (p = 0.45). Functional bladder capacity was not significantly different in patients dry after treatment (p = 0.82).
  
  
  CONCLUSIONS
  This retrospective study demonstrates similar response to a single treatment with intravesical Botulinum type-A toxin to previous series. We did not demonstrate a correlation between dose or functional bladder capacity and resolution of incontinence. A multi-centre study is required to further investigate this promising treatment.
authors.affiliation: Department of Paediatric Urology, University Hospital Southampton NHS Foundation Trust, United Kingdom.
authors.forename: S C
authors.initials: SC
authors.lastname: Blackburn
authors.forename: C
authors.initials: C
authors.lastname: Jones
authors.forename: S
authors.initials: S
authors.lastname: Bedoya
authors.forename: H A
authors.initials: HA
authors.lastname: Steinbrecher
authors.forename: P S
authors.initials: PS
authors.lastname: Malone
authors.forename: S J
authors.initials: SJ
authors.lastname: Griffin
mesh_terms: D000283:Administration, Intravesical; D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014549:Urinary Incontinence / Q000188:drug therapy*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA