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19–22 APRIL, 2017, BARCELONA, SPAIN
S24: NEUROPATHIC BLADDER 1
Moderators: Wout Feitz (Netherlands), Rafal Chrzan (Poland)
ESPU Meeting on Saturday 22, April 2017, 11:48–12:40
11:48–11:53
S24-1 (LO)
★
BOTULINUM TOXINE TYPE A THERAPY: INTRAVESICAL
INJECTION OR ELECTROMOTIVE DRUG ADMINSTRATION
Seyedeh-Sanam LADI-SEYEDIAN
1
, Lida SHARIFI RAD
2
and Abdol-Mohammad KAJBAFZADEH
1
1) Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center
Children’s Hospital Medical Center, Tehran, ISLAMIC REPUBLIC OF IRAN - 2) Tehran University of Medical Sciences,
Department of Physical Therapy, Children’s Hospital Medical Center, Pediatric Center of Excellence, Tehran, ISLAMIC
REPUBLIC OF IRAN
PURPOSE
In recent years, BoNTA has progressively been used to manage conditions characterized by
neuropathic detrusor overactivity (NDO). In this study, we compared the outcomes of intravesical
BoNTA injection to intravesical BoNTA electromotive administration (EMDA) for treatment of urinary
incontinence secondary to NDO in MMC children.
MATERIAL AND METHODS
A total of 24 MMC patients (11 boys, 13 girls; mean age 7.5±2.5) with urinary incontinence second-
ary to NDO were enrolled in the study and were randomly divided into two equal treatment groups.
10 IU/kg of BoNTA was inserted into the bladder of the patients in EMDA group (n=12); by using
an electrode-catheter, without anesthesia and on an outpatient basis. The EMDA equipment was
connected to the electrode of an indwelling catheter and 2 dispersive electrodes, a pulsed current
generator delivered 10 mA for 20 minutes. Patients in injection group (n=12) received interavesical
injection of 10 IU/kg of BoNTA via rigid cystoscope on an inpatient basis. For all patients, a voiding
diary, a UDS and kidney and bladder ultrasounds were performed before 6 months and one year
after the treatment.
RESULTS
9/12(75%) and 6/12(50%) of patients in EMDA and injection groups were completely dry between
two consecutive CICs one year after the treatment. Mean detrusor pressure decreased significantly
in EMDA group compared to injection group (40± 13 vs. 57±2 3 cmH2O, P<0.04) at one year follow
up.
CONCLUSIONS
Patients in both groups improved after the treatment; however improvement in EMDA group was
more prominent with better sustained effects. Moreover, BoNTA/EMDA is a feasible, reproducible,
cost benefit and pain free method as an outpatient basis and there is no need for anesthesia.