title: Efficacy of onabotulinum toxin A injection in pediatric patients with non-neurogenic detrusor overactivity.
abstract: OBJECTIVE
  To evaluate the effectiveness and reliability of onabotulinum toxin A (onaBoNT-A) injections in pediatric patients with non-neurogenic detrusor overactivity (NNDO).
  
  
  METHODS
  Between January 2010 and February 2016, 39 patients underwent onaBoNT-A injections for NNDO, and were evaluated retrospectively. Three-day voiding diary was filled at baseline, and at the postoperative 9th month. The voiding frequency, incontinence episodes, and the cystometric capacity were noted. Vesicoureteral reflux (VUR) associated with NNDO, and presence of nocturia were recorded. Additional injection requirements were also stated.
  
  
  RESULTS
  We reached the data of 33 patients on 9th month. The mean age was determined as 8.75 ± 3.01 (5-16) years. Initially, the mean bladder capacity was calculated as 114.66 ± 35.23 mL on the voiding diary, and 153.15 ± 47.40 mL on the baseline urodynamic study. After the procedures, the mean bladder capacity increased to 140.84 ± 45.61 mL (P = 0.0011), the mean daily voiding frequency decreased from 10.36 ± 1.05 to 7.42 ± 0.83 (P = 0.01), and the mean incontinence episodes decreased from 2.72 ± 1.87 to 1.18 ± 1.13 (P = 0.001), on voiding diary. VUR associated with NNDO was determined in 10 (30.3%) patients. The degree of VUR decreased three in patients, and VUR disappeared in five patients following the injections (P = 0.011). Fourteen (42.4%) patients had nocturia, and after the injections, nocturia disappeared in five (15.15%) patients (P = 0.151). Additional injections were required in 10 (30.3%) patients at the 9th month.
  
  
  CONCLUSIONS
  OnaBoNT-A injections can be used in the pediatric patients with NNDO as an effective and reliable procedure by decreasing voiding frequency, incontinence episodes, and increasing bladder capacity, with negligible side effects and complications.
authors.affiliation: Department of Urology, University of Gaziantep, Gaziantep, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Bayrak
authors.affiliation: Department of Urology, University of Gaziantep, Gaziantep, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Sadioglu
authors.affiliation: Department of Urology, University of Gaziantep, Gaziantep, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Sen
authors.affiliation: Department of Urology, University of Gaziantep, Gaziantep, Turkey.
authors.forename: Kazim
authors.initials: K
authors.lastname: Dogan
authors.affiliation: Department of Urology, University of Gaziantep, Gaziantep, Turkey.
authors.forename: Sakip
authors.initials: S
authors.lastname: Erturhan
authors.affiliation: Department of Urology, University of Gaziantep, Gaziantep, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Seckiner
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D053158:Nocturia / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D014549:Urinary Incontinence / Q000209:etiology; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: detrusor overactivity; non-neurogenic; onabotulinum toxin A; pediatric