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19–22 APRIL, 2017, BARCELONA, SPAIN
11:58–12:01
S24-3 (PP)
SAFETY AND EFFICIACY OF BOTULINUM-A TOXIN
IN THE TREATMENT OF NEUROGENIC BLADDER
DYSFUNCTION IN INFANTS AND CHILDREN
Marleen VAN DEN HEIJKANT, Guy BOGAERT and Dries DEVELTERE
UZLeuven, Gasthuisberg Campus, Pediatric urology, Leuven, BELGIUM
PURPOSE
To investigate the safety and efficacy of Botulinum-A toxin (BTX-A) in the treatment of neurogenic
bladder dysfunction in infants and children who are on clean intermittent catheterization to ensure
low bladder pressures.
MATERIAL AND METHODS
Infants and children (<12yr) with neurogenic bladder dysfunction under anticholinergic medication
(oral or intravesical) and clean intermittent catheterization suffering from side effects or persistent
high-pressure bladder were included in this prospective and ethical accepted study. Urodynamic
studies were performed before and 6 weeks after BTX-A injections. BTX-A injections were
performed at a dosage of 12 IU/kg (20injections) with a maximum dose of 300 IU under general
anesthesia. The Wilcoxon signed rank test was used to compare urodynamic data before and after
BTX-A injections ( p<0.01).
RESULTS
14 patients (median age 4,9yr range 16mo-9,2yr) were included. The maximum bladder capacity
increased by 143%, from median 75 ± 18 ml to 182 ± 14 ml. The maximum detrusor pressure during
filling significantly decreased by 53%, from median 59 ± 15 cmH
2
O to 28 ± 6 cmH
2
O. The detrusor
leak pressure decreased by 70%, from median 56 ± 15 cmH
2
O to 17 ± 6 cm H
2
O. No immediate or
short-term adverse events were reported.
CONCLUSIONS
BTX-A injections can be a safe and efficient alternative to anticholinergic medication in infants and
young children patients with a neurogenic bladder and a high-pressure bladder. BTX-A injections
could become a valuable bridging therapy between anticholinergic medication and ultimate surgery
to maintain a continuous low-pressure bladder.
12:01–12:04
S24-4 (PP)
URODYNAMIC EFFICACY OF MIRABEGRON IN PEDIATRIC
PATIENTS WITH SPINA BIFIDA
Yong Seung LEE
1
, Sang Woon KIM
1
, Sung Ku KANG
1
, Sung Hoon KIM
2
,
Ju Hee CHON
2
, Su Yeon KIM
2
, Yong Jae IM
3
and Sang Won HAN
1
1) Yonsei University College of Medicine, Department of Urology, Seoul, REPUBLIC OF KOREA - 2) Severance
Children’s Hospital, Department of Pediatric Urology, Seoul, REPUBLIC OF KOREA - 3) Seoul National University
College of Medicine, Department of Urology, Seoul, REPUBLIC OF KOREA
PURPOSE
To analyze the urodynamic efficacy of Mirabegron in pediatric patients with spina bifida.