265 / 330
265
19–22 APRIL, 2017, BARCELONA, SPAIN
MATERIAL AND METHODS
Eighty two patients under 18 years old with neurogenic bladder were evaluated, mostly by spinal
dysraphia. All patients were refractory to oral oxybutynin. We reinjected OnabotulinumtoxinA be-
tween 9 and 12 months, if there were clinical and / or urodynamic improvement after the third month
of the first injection. Otherwise, we indicated bladder augmentation.
RESULTS
We reinjected OnabotulinumtoxinA, two, three, four and five times: 20 cases, 7, 4 and one case,
respectively. In 51% average total urinary continence (zero-dry score) was achieved. In the first
and second injection there were significant increases in average cystometric capacity: 331 ml from
254 to (p: 0.007) and 257-367 ml (p: 0.014); respectively. The compliance of bladder wall in some
cases, improved, after the first injection: from 6.9 to 11.4 ml / cmH2O (p: 0.05). Mean detrusor
pressure at end of filling decreased from 41 to 38 cmH2O.
Detrusor overactivity (n: 22) was attenuated in 54.4% after the first injection. Any major adverse
effects were reported with reinjection.
Fifteen patients refractory to OnabotulinumtoxinA were intervened for bladder augmentation.
CONCLUSIONS
The treatment with OnabotulinumtoxinA achieved urinary continence in average 50%. The
Cystometric capacity increased significantly with the first two injections; although it was not accompa-
nied by a significant parallel decrease in intravesical pressures. The use of the OnabotulinumtoxinA
has been delayed the classic indication of bladder augmentation in refractory to anticholinergic
children.
S24-13 (P without presentation)
ARE UROLOGICAL ANOMALIES MORE COMMON
IN NEWBORNS WITH SPINA BIFIDA WITH UPPER LESIONS
COMPARED WITH LOWER?
Claire CULLEN
1
, Orla MCMAHON
2
, Emer ALDRIDGE
3
, Malcolm LEWIS
4
and Salvatore CASCIO
3
1) Temple Street Children’s University Hospital, Paediatric Surgery, Dublin, IRELAND - 2) Temple Street
Children’s University Hospital, Paediatric Urology, Dublin, IRELAND - 3) Temple Street Children’s University Hospital,
Paediatric Urology, Dublin, IRELAND - 4) Temple Street Children’s University Hospital, Paediatric Nephrology, Dublin,
IRELAND
PURPOSE
The large majority of newborns with myelodysplasia are born with a normal renal tract. However,
a small percentage of those born with neural tube defects have associated urological anomalies.
It is suggested that the level of spinal lesion correlates to specific renal anomalies. The aim of this
study is to examine the relationship between spinal dysraphism and renal anomalies.
MATERIAL AND METHODS
We retrospectively reviewed our database of children with spina bifida. Data analysis included
demographics, level of lesion, renal ultrasound and urological intervention. Spinal lesions were
separated into seven groups; encephalocele, thoracic, thoracolumbar, thoracosacral, lumbar,
lumbosacral and sacral.
RESULTS
381 patients were identified. 133 were excluded due to moving abroad, incomplete investigations
or being lost to follow up. Of the remaining 248 patients, there were 22 encephalocele, 8 thoracic,
17 thoracolumbar, 17 thoracosacral, 33 lumbar, 86 lumbosacral and 65 sacral.