Intravesical Injections of Botulinum Toxin Type A for Management of Neuropathic Bladder: A Comparison of Two Methods

Safari, Saeid; Jamali, Sarah; Habibollahi, Peiman; Arshadi, Hamid; Nejat, Farideh; Kajbafzadeh, Abdol-Mohammad

doi:10.1016/j.urology.2009.09.087

Cited by 32 publications

(28 citation statements)

References 22 publications

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“…Moreover, the use of onaBNTa is less invasive than sacral neuromodulation (SNM) or bladder augmentation. Patients preferred botulinum toxin over the SNM as has been reported in several studies . A standardized protocol to manage a specific pathological condition allows clinicians to better identify those subjects who do not respond to first line treatment and lets them to choose an alternative therapeutic option when necessary.…”

Section: Discussionmentioning

confidence: 90%

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%

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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“…Neel et al [18, 22] reported a successful experience in total endoscopic management of children with non-compliant neuropathic bladder. There was a good effect on treating VRR when BTX-A injection was combined with endoscopic subureteral injection.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up after botulinum toxin A (BTX-A) injection into the detrusor for treatment of neurogenic detrusor hyperactivity in children

et al. 2012

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PurposeTo prove the long-term efficacy of BTX-A injection in the management of children with neurogenic detrusor hyperactivity.Materials and methods28 out of 145 children with neurogenic bladder (15 male and 13 female, mean age 10.7 years) who were treated between 2002 and 2010 and became non-responders to conservative treatment were included into the retrospective study.We injected 10-12 U/kg of BTX-A (Botox®) into the detrusor at 20-30 sites, sparing the trigone. The mean follow-up was 48 months (range 6-84 months).ResultsGroup 1. 14 patients had a single injection of BTX-A. Five of them were successful.Mean bladder reflex volume increased (from 62.9 to 117.5 ml), maximum detrusor pressure decreased (from 59 to 37.5 cm H2O), detrusor compliance increased (from 4.8 to 9.5 ml/cm H2O), and leak-point-pressure decreased (from 46.5 to 24.2 cm H2O). Four patients did not respond and were treated by ileocystoplasty. Another five were lost to follow-up. Group 2. 14 patients had repeated (mean 2.5) injections of BTX-A with a mean interval of 13.7 months. In thirteen patients, urodynamic parameters of the first and last injection were similar to those obtained in Group 1, showing a good response. One patient received an ileocystoplasty.ConclusionBTX-A is a safe alternative in the treatment of detrusor hyperactivity in children with myelomeningocele (MMC). The efficacy lasted a mean of 12 months and urodynamic response was unchanged even after several injections. In our series, 21.7% of children with severe low-compliance bladders were non-responders.

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“…107 In paediatric patients with myelomeningocele and DSD, BoNTA injections into the urethral sphincter at a dose of 2 units per kg plus detrusor injections at a dose of 8 units per kg significantly decreased PVR volume, incidence of urinary incontinence, constipation, vesico ureteral reflux and serum creatinine levels compared with i ntradetrusor injection alone at a dose of 10 units per kg. 108 Paediatric patients with nonneurogenic OAB that is refractory to antimuscarinic therapy can also benefit from intradetrusor BoNTA injections. Repeat injec tions 6-7 months after initial treatment were also proven to be as effective as the initial treatment in terms of both clinical and urodynamic outcomes.…”

Section: Ndo Owing To Neuropathiesmentioning

confidence: 99%

Current and potential urological applications of botulinum toxin A

Jiang

Liao

2015

Nat Rev Urol

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Botulinum toxin subtype A (BoNT-A) is a potent neurotoxin that can selectively modulate neurotransmitter release from nerve endings, resulting in muscular paralysis. BoNT-A might also act on sensory nerves, and have an anti-inflammatory effect. In the first urological use of BoNT-A, injection into the urethral sphincters of patients with detrusor-sphincter dyssynergia resulted in a reduction of urethral resistance and improved voiding efficiency. Subsequently, intravesical BoNT-A injections have received regulatory approval for treatment of neurogenic detrusor overactivity owing to spinal cord lesions or multiple sclerosis, and idiopathic overactive bladder in adults. BoNT-A has also been widely used to treat patients with the off-label indications of neurogenic or non-neurogenic voiding dysfunction and male lower urinary tract symptoms owing to BPH and bladder-neck dysfunction. Other indications for which urologists have applied BoNT-A injections include interstitial cystitis/bladder pain syndrome, bladder oversensitivity and chronic pelvic pain syndrome. BoNT-A is currently delivered as an intravesical injection; however, use of liposome encapsulated formulations is also beginning to show some therapeutic potential.

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Intravesical Injections of Botulinum Toxin Type A for Management of Neuropathic Bladder: A Comparison of Two Methods

Cited by 32 publications

References 22 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

Long-term follow-up after botulinum toxin A (BTX-A) injection into the detrusor for treatment of neurogenic detrusor hyperactivity in children

Current and potential urological applications of botulinum toxin A

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