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Botulinum Toxin Type A Therapy: Intravesical Injection or Electromotive Drug Administration.
- Source :
-
Urology [Urology] 2020 Aug; Vol. 142, pp. 190-194. Date of Electronic Publication: 2020 May 11. - Publication Year :
- 2020
-
Abstract
- Objectives: To compare the outcomes of intravesical injection of botulinum toxin A (BoNTA) with intravesical electromotive drug administration (EMDA) of BoNTA on urinary incontinence secondary to neuropathic detrusor overactivity (NDO) in children with myelomeningocele (MMC).<br />Materials and Methods: A total of 26 children with MMC (11 boys, 15 girls) who had urinary incontinence secondary to NDO were retrospectively enrolled in the study. Patients in EMDA group (n = 14), using an electrode-catheter, 10 IU/kg of BoNTA were inserted into the bladder for EMDA without anesthesia and on an outpatient basis. The EMDA equipment was connected to the electrode of indwelling catheter and 2 dispersive electrodes, a pulsed current generator delivered 10-20 mA for 20 minutes. Patients in injection group (n = 12) were received interavesical injection of 10 IU/kg of BoNTA via rigid cystoscope on an inpatient basis. All patients had been evaluated by a voiding diary, urodynamic study, renal, and bladder ultrasounds before, 6 months and 1 year after the treatment.<br />Results: Six months after the treatment, 12 of 14 (85.7 %) and 8 of 12 (66.6%) patients in EMDA and injection groups respectively became completely dry between 2 consecutive clean intermittent catheterizations, which maintained in 11 of 14 (78.5%) of patients in EMDA group compared to 6 of 12 (50%) of patients in injection group, 1 year after the treatment.<br />Conclusion: Patients in both groups improved after the treatment; however improvement in EMDA group was more prominent with better sustained effects. BoNTA/EMDA is a feasible, reproducible, cost benefit, and pain free method as an outpatient basis and no need for anesthesia.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Administration, Intravesical
Adolescent
Catheters, Indwelling
Child
Child, Preschool
Electrodes
Feasibility Studies
Female
Follow-Up Studies
Humans
Intermittent Urethral Catheterization statistics & numerical data
Male
Retrospective Studies
Treatment Outcome
Urinary Bladder, Neurogenic etiology
Urinary Bladder, Overactive etiology
Urinary Catheters
Urinary Incontinence etiology
Botulinum Toxins, Type A administration & dosage
Meningomyelocele complications
Urinary Bladder, Neurogenic therapy
Urinary Bladder, Overactive therapy
Urinary Incontinence therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1527-9995
- Volume :
- 142
- Database :
- MEDLINE
- Journal :
- Urology
- Publication Type :
- Academic Journal
- Accession number :
- 32437774
- Full Text :
- https://doi.org/10.1016/j.urology.2020.04.104