Voskamp, M.J. H. (Maarten) (2013) BOTULINUM-A TOXIN AS A TREATMENT OF OVERACTIVE BLADDER IN CHILDREN. thesis, Medicine.
Full text available on request.Abstract
Introduction: An overactive bladder is the second most common bladder dysfunction found among children. Because medication is not always effective, botulinum-A toxin injections into the bladder wall have been applied since 2002. This treatment had already been included in the guidelines for adults. However, in children there is little experience in the use of this relatively new agent. This study investigates the efficacy and safety of the administering of botulinum-A toxin to children. This study also investigates the usefulness of urodynamic testing in evaluating the treatments using botulinum-A toxin. Method: Between 2004 and 2012, 62 children were submucosally administered botulinum-A toxin (Botox®). The average dose was 6.5 U/Kg, with a maximum dose of 300 U. Medical files were analyzed retrospectively according to surgery reports, medical histories and bladder diaries. Data about age, type of bladder overactivity, micturition and incontinence was collected. In addition, treatment characteristics, such as dosages and the number and sites of injections were listed. Urodynamic tests were performed on 22 children prior to and following treatment. The results of these tests were compared to symptomatic changes. Results: Fifty of the 62 children were affected by an overactive bladder. The mean age of these children was 9 years (range 3-16). Of the 95 treatments that were carried out, adverse events were reported in 9 cases. After treatment with botulinum-A toxin, 37 of the 50 children (74%) showed symptomatic improvement after an average of 9 weeks (range 3-17). Seven of the 50 children (14%) showed no improvement and, in the case of 6 children, there was insufficient follow-up data. On average, incontinence decreased and bladder capacity increased. There proved to be no correlation between symptomatic improvements and urodynamic findings. Conclusion: Botulinum-A toxin is an effective treatment and provides symptomatic improvement among 74% of children affected by a therapy-resistant overactive bladder. Urodynamic tests following treatment with botulinum-A toxin generally provide no new insight and may therefore be omitted.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor and Nijman, prof. dr. J.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2472 |
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