A Simplified Technique for Botulinum Toxin Injections in Children With Neurogenic Bladder

Pascali, Maria Paola; Mosiello, Giovanni; Marciano, Armando; Capitanucci, Maria Luisa; Zaccara, Antonio; Gennaro, M. De

doi:10.1016/j.juro.2011.01.037

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…Some of the most important aspects of adulthood should be considered: sexuality has an important role and it should be considered, especially regarding urinary incontinence. Urinary incontinence NDO related has been found to have a significant negative impact on sexuality, causing embarrassment and decreasing the quality of life (QoL) …”

Section: Discussionmentioning

confidence: 90%

“…Urinary incontinence NDO related has been found to have a significant negative impact on sexuality, causing embarrassment and decreasing the quality of life (QoL). 18,54,55 Adoles-Adolescents should be carefully protected by these negative consequences of NDO which could determine withdrawal from sexual activity and depression. Legal aspects should be taken into consideration: becoming adults, these patients will have to sign an informed consent to have a treatment.…”

Section: Discussionmentioning

confidence: 99%

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Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

Palleschi

Mosiello

Iacovelli

et al. 2017

Neurourology and Urodynamics

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This manuscript represents the first report on the onaBNTa in adolescents. Young adults should be treated as a distinct sub-population in policy, planning, programming, and research, as strongly sustained by national public health care. This consensus and the algorithm could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

Palleschi

Mosiello

Iacovelli

et al. 2017

Neurourology and Urodynamics

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“…Each injection was 1 mL (10 U/1 mL of saline solution), preferably into the trabeculae, with a maximum depth of 5 mm (Figure 3). Particular attention was paid to exclude trigone and blood vessels from the injection [7]. All patients underwent an endoscopic cold-cup biopsy (Figure 4) immediately before BTX-A injection, from the posterolateral bladder wall 1.5 to 2 cm above the ureteral orifice.…”

Section: Methodsmentioning

confidence: 99%

Onabotulinum Toxin A Intradetrusor Injections in Children with Neurogenic Lower Urinary Tract Dysfunction: Long-Term Histological Effects on the Bladder Wall

et al. 2023

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Background: In the last twenty-five years, Onabotulinum Toxin A (BTX-A) has gained increasing popularity for neurogenic lower urinary tract dysfunction (NLUTD) treatment. To maintain its efficacy, repeated BTX-A intradetrusor injections are required over time, with unknown effects on the bladder wall in children. The aim of this paper is to report long-term effects on the bladder wall in children treated with BTX-A. Methods: Children with NLUTD not responsive to anticholinergics were treated with BTX-A, according to our protocol, with bladder wall control using endoscopic cold-cup biopsy. Specimens were evaluated considering edema, chronic inflammation, and fibrosis. Results: Of the 230 patients treated from 1997 to 2022, we considered only specimens obtained in patients who had received ≥5 treatments (36 children), considered as the threshold to evaluate clinical effectiveness on long-term treatment with BTX-A. Most of them had congenital NLUTD (25 patients) and detrusor overactivity (27 patients). In all, increased edema and chronic inflammation with reduced fibrosis over time was reported; these data were not statistically significant. No difference was observed between patients with congenital and acquired diseases. Conclusions: Repeated intradetrusor BTX-A injections are not related to significant histological alterations in children, similarly with adults, and repeated injections could be considered safe.

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“…At present, there are no comparative studies published that analyze this aspect of injection. There is, however, evidence of an intention to simplify the injection technique, for instance with the use of different devices, such as endoinjector needle systems, with curved needles that can reach difficult endovesical sites, like lateral walls or bladder roof and trabecular region [20, 21]. …”

Section: Administration Of Botulinum Toxin Type a In The Detrusor mentioning

confidence: 99%

“…Botulinum toxin, in blocking the release of acetylcholine, diminishes muscular contraction and the nerve growth factor. It also inhibits release of inflammatory mediators which induce fibrosis [20, 21]. …”

Section: Fibrosismentioning

confidence: 99%

Pharmacotherapy in Pediatric Neurogenic Bladder Intravesical Botulinum Toxin Type A

et al. 2012

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When the neurogenic bladder is refractory to anticholinergics, botulinum toxin type A is used as an alternative. The neurotoxin type A reduces bladder pressure and increases its capacity and wall compliance. Additionally, it contributes to improving urinary continence and quality of life. This novel therapy is ambulatory with a low incidence of adverse effects. Due to its transitory effect, it is necessary to repeat the injections in order to sustain its therapeutic effect. In these review article we talk about Mechanism of Action, Indications, effects, administration and presentations of the Botulinum Neurotoxin Type A in pediatric patients. Also, we make references to controversial issues surrounding its use. A bibliographic search was done selecting articles and revisions from Pubmed. The key words used were botulinum toxin A, neurogenic bladder, and children. The search was limited to patients younger than 18 years of age and reports written in English in the past ten years.

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A Simplified Technique for Botulinum Toxin Injections in Children With Neurogenic Bladder

Abstract: While retaining efficacy, the endo-injector needle technique appears to be more rapid than the standard procedure for botulinum toxin type A injection for neurogenic bladder dysfunction. Whether patients may be treated with sedation only remains to be clarified.

Cited by 12 publications

References 25 publications

Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

Onabotulinum Toxin A Intradetrusor Injections in Children with Neurogenic Lower Urinary Tract Dysfunction: Long-Term Histological Effects on the Bladder Wall

Pharmacotherapy in Pediatric Neurogenic Bladder Intravesical Botulinum Toxin Type A

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