Urinary incontinence in children: botulinum toxin is a safe and effective treatment option

McDowell, Dermot T.; Noone, Damien; Tareen, Farhan; Waldron, Mary; Quinn, Feargal

doi:10.1007/s00383-011-3039-5

Cited by 34 publications

(27 citation statements)

References 19 publications

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“…109 Published data are continuing to demonstrate that detrusor BoNTA injection is a safe and effective treat ment of urinary incontinence episodes in children with nonneurogenic OAB. 110,111 Dysfunctional voiding is highly prevalent in paedi atric patients with NDO or nonneurogenic OAB. 112 Injections of BoNTA at a dose of 50-100 units resulted in normalization of the voiding curve and decreased PVR volume in this patient population.…”

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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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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“…El efecto es temporal, de 6 a 9 meses, y se requieren inyecciones repetidas (54). Se ha encontrado respuesta completa en 74,2 % de los hombres y 54,5 % de las mujeres y respuesta parcial en 20 % de los hombres y 18,2 % de las mujeres (55). Los posibles efectos adversos son retención urinaria, cistitis y riesgo de infección del tracto urinario (25).…”

Section: Tratamiento Farmacológico Anticolinérgicosunclassified

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Guerrero-Tinoco

Cano-Martínez

Vanegas-Ruiz

2018

iatreia

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RESUMENLa disfunción miccional es un trastorno del llenado o vaciado de la vejiga en niños sin alteraciones neurológicas o anatómicas. Los síntomas del tracto urinario inferior (LUTS, por la sigla en inglés de Lower urinary tract symptoms) son un motivo frecuente de consulta con el pediatra, el nefrólogo o el urólogo pediatra, e incluso con el neurólogo y el psicólogo infantil. Se le considera una enfermedad relativamente benigna lo que en ocasiones genera desinterés entre médicos y familiares y lleva a consultas tardías e interpretación inadecuada de los síntomas. Manifestaciones como urgencia, incontinencia, enuresis, goteo posmiccional, infecciones urinarias, vulvovaginitis recurrente y constipación, en un niño sin enfermedad neurológica, deben hacer pensar al médico en disfunción miccional para enfocar oportunamente el diagnóstico, restablecer la calidad de vida del paciente, evitar las infecciones urinarias y el daño renal subsecuente e irreversible secundario a un diagnóstico tardío. Las recomendaciones actuales hacen énfasis en un enfoque menos invasivo, tratamiento conservador, manejo de la constipación y reentrenamiento vesical. Este artículo discute la evaluación, el diagnóstico y el tratamiento correctos de niños con LUTS.

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“…Several recent publications have reported the use of BTA for idiopathic detrusor overactivity in children refractory to other forms of therapy [41]. McDowell et al presented a series of 57 patients with OAB resistant to standard urotherapy who were treated with BTA and antimuscarinics [42]. These authors observed success in 74.2 % of males and 54.5 % of females and partial success in 20 % of males and 18.2 % of females [42].…”

Section: Day Wettingmentioning

confidence: 99%

“…McDowell et al presented a series of 57 patients with OAB resistant to standard urotherapy who were treated with BTA and antimuscarinics [42]. These authors observed success in 74.2 % of males and 54.5 % of females and partial success in 20 % of males and 18.2 % of females [42]. The effect is unfortunately not permanent, lasting only 6–9 months, and repeated injections are necessary.…”

Section: Day Wettingmentioning

confidence: 99%

The management of childhood urinary incontinence

2014

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The International Children’s Continence Society (ICCS) has undertaken an enormous effort to standardize both the terminology and management of various aspects of incontinence in children, including enuresis, bladder overactivity, dysfunctional voiding and psychological comorbidities. A number of guidelines have been published to aid those involved in the care of children with lower urinary tract symptoms. This review addresses a number of recommended diagnostic and therapeutic strategies, including urotherapy and pharmacological treatment, with emphasis on a focused medical history, information acquired from bladder diaries and uroflow evaluations. The major role of urotherapy is underlined with supportive pharmacotherapy, when indicated. The article provides both a summary of ICCS guidelines and a brief review of recently published papers related to the contemporary management of childhood incontinence, a health issue still underestimated by both the child’s caregivers and healthcare providers.

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Urinary incontinence in children: botulinum toxin is a safe and effective treatment option

Abstract: BoNT-A has a role in a carefully selected subgroup of children with overactive bladder symptoms including those with medication side effects and treatment compliance issues. It may have a role in patients who do not respond to conventional therapy.

Cited by 34 publications

References 19 publications

Current and potential urological applications of botulinum toxin A

Current and potential urological applications of botulinum toxin A

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

The management of childhood urinary incontinence

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