Efficacy of Intravesical Botulinum Toxin A Injection in the Treatment of Refractory Overactive Bladder in Children
<p>Change in bladder compliance, detrusor pressure, and cystometric capacity, comparing neurogenic OAB group with non-neurogenic OAB group after BoNT-A injection. There was no significant improvement in bladder compliance, detrusor pressure, or cystometric capacity between groups.</p> "> Figure 2
<p>Change in bladder compliance, detrusor pressure, and cystometric capacity, comparing bladder BoNT-A group with bladder plus urethra BoNT-A group after BoNT-A injection. There was no significant improvement in compliance, detrusor pressure, or cystometric capacity between groups.</p> ">
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Subjects
2.2. Urodynamic Assessment
2.3. BoNT-A Injection
2.4. Outcome Measures
2.4.1. Primary Outcome
2.4.2. Secondary Outcome
2.5. Statistical Analysis
3. Results
3.1. Urodynamic Outcomes
3.1.1. Neurogenic OAB vs. Non-Neurogenic OAB
3.1.2. Bladder BoNT-A Only vs. Bladder plus Urethral Sphincter BoNT-A
3.2. Subjective Therapeutic Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Austin, P.F.; Bauer, S.B.; Bower, W.; Chase, J.; Franco, I.; Hoebeke, P.; Rittig, S.; Walle, J.V.; von Gontard, A.; Wright, A.; et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children’s Continence Society. Neurourol. Urodyn. 2016, 35, 471–481. [Google Scholar] [CrossRef] [PubMed]
- Ramsay, S.; Bolduc, S. Overactive bladder in children. Can. Urol. Assoc. J. 2017, 11, S74–S79. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Franco, I. Overactive bladder in children. Nat. Rev. Urol. 2016, 13, 520–532. [Google Scholar] [CrossRef] [PubMed]
- Bauer, S.B.; Austin, P.F.; Rawashdeh, Y.F.; de Jong, T.P.; Franco, I.; Siggard, C.; Jorgensen, T.M. International Children’s Continence Society’s recommendations for initial diagnostic evaluation and follow-up in congenital neuropathic bladder and bowel dysfunction in children. Neurourol. Urodyn. 2012, 31, 610–614. [Google Scholar] [CrossRef] [PubMed]
- Bauer, S.B.; Labib, K.B.; Dieppa, R.A.; Retik, A.B. Urodynamic evaluation of boy with myelodysplasia and incontinence. Urology 1977, 10, 354–362. [Google Scholar] [CrossRef]
- Wu, S.Y.; Chang, S.J.; Yang, S.S.; Hsu, C.K. Botulinum Toxin Injection for Medically Refractory Neurogenic Bladder in Children: A Systematic Review. Toxins 2021, 13, 447. [Google Scholar] [CrossRef]
- Chung, J.M.; Lee, S.D.; Kang, D.I.; Kwon, D.D.; Kim, K.S.; Kim, S.Y.; Kim, H.G.; Moon, D.G.; Park, K.H.; Park, Y.H.; et al. Prevalence and associated factors of overactive bladder in Korean children 5–13 years old: A nationwide multicenter study. Urology 2009, 73, 63–67. [Google Scholar] [CrossRef]
- Nieuwhof-Leppink, A.J.; Schroeder, R.P.J.; van de Putte, E.M.; de Jong, T.; Schappin, R. Daytime urinary incontinence in children and adolescents. Lancet Child Adolesc. Health 2019, 3, 492–501. [Google Scholar] [CrossRef]
- Lee, B.; Featherstone, N.; Nagappan, P.; McCarthy, L.; O’Toole, S. British Association of Paediatric Urologists consensus statement on the management of the neuropathic bladder. J. Pediatr. Urol. 2016, 12, 76–87. [Google Scholar] [CrossRef]
- Orasanu, B.; Mahajan, S.T. The use of botulinum toxin for the treatment of overactive bladder syndrome. Indian J. Urol. 2013, 29, 2–11. [Google Scholar] [CrossRef]
- Kuo, H.C. Clinical Application of Botulinum Neurotoxin in Lower-Urinary-Tract Diseases and Dysfunctions: Where Are We Now and What More Can We Do? Toxins 2022, 14, 498. [Google Scholar] [CrossRef] [PubMed]
- General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. J. Am. Coll. Dent. 2014, 81, 14–18. [Google Scholar]
- Bauer, S.B.; Nijman, R.J.; Drzewiecki, B.A.; Sillen, U.; Hoebeke, P. International Children’s Continence Society standardization report on urodynamic studies of the lower urinary tract in children. Neurourol. Urodyn. 2015, 34, 640–647. [Google Scholar] [CrossRef] [PubMed]
- Hsiao, S.M.; Lin, H.H.; Kuo, H.C. Factors Associated with Therapeutic Efficacy of Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Syndrome. PLoS ONE 2016, 11, e0147137. [Google Scholar] [CrossRef] [PubMed]
- Abedi, A.; Sayegh, A.S.; Ha, N.T.; La Riva, A.; Perez, L.C.; Kohli, P.; Abedi, A.; Jen, R.P.; Ginsberg, D.A.; Kreydin, E.I. Health Care Economic Burden of Treatment and Rehabilitation for Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review. J. Urol. 2022, 208, 773–783. [Google Scholar] [CrossRef]
- Kim, S.W.; Choi, J.H.; Lee, Y.S.; Han, S.W.; Im, Y.J. Preoperative urodynamic factors predicting outcome of botulinum toxin-A intradetrusor injection in children with neurogenic detrusor overactivity. Urology 2014, 84, 1480–1484. [Google Scholar] [CrossRef] [PubMed]
- Hascoet, J.; Peyronnet, B.; Forin, V.; Baron, M.; Capon, G.; Prudhomme, T.; Allenet, C.; Tournier, S.; Maurin, C.; Cornu, J.N.; et al. Intradetrusor Injections of Botulinum Toxin Type A in Children with Spina Bifida: A Multicenter Study. Urology 2018, 116, 161–167. [Google Scholar] [CrossRef]
- Kajbafzadeh, A.M.; Moosavi, S.; Tajik, P.; Arshadi, H.; Payabvash, S.; Salmasi, A.H.; Akbari, H.R.; Nejat, F. Intravesical injection of botulinum toxin type A: Management of neuropathic bladder and bowel dysfunction in children with myelomeningocele. Urology 2006, 68, 1091–1096. [Google Scholar] [CrossRef]
- Marte, A.; Borrelli, M.; Sabatino, M.D.; Balzo, B.D.; Prezioso, M.; Pintozzi, L.; Nino, F.; Parmeggiani, P. Effectiveness of botulinum-A toxin for the treatment of refractory overactive bladder in children. Eur. J. Pediatr. Surg. 2010, 20, 153–157. [Google Scholar] [CrossRef]
- Hoebeke, P.; De Caestecker, K.; Vande Walle, J.; Dehoorne, J.; Raes, A.; Verleyen, P.; Van Laecke, E. The effect of botulinum-A toxin in incontinent children with therapy resistant overactive detrusor. J. Urol. 2006, 176, 328–331. [Google Scholar] [CrossRef]
- Al Edwan, G.M.; Mansi, H.H.; Atta, O.N.M.; Shaath, M.M.; Al Adwan, R.; Mahafza, W.; Afram, K.M.; Ababneh, O.; Al Adwan, D.; Muheilan, M.M. Objective and subjective improvement in children with idiopathic detrusor overactivity after intravesical botulinum toxin injection: A preliminary report. J. Pediatr. Surg. 2019, 54, 595–599. [Google Scholar] [CrossRef] [PubMed]
- Dykstra, D.D.; Sidi, A.A. Treatment of detrusor-sphincter dyssynergia with botulinum A toxin: A double-blind study. Arch. Phys. Med. Rehabil. 1990, 71, 24–26. [Google Scholar] [PubMed]
- de Seze, M.; Petit, H.; Gallien, P.; de Seze, M.P.; Joseph, P.A.; Mazaux, J.M.; Barat, M. Botulinum a toxin and detrusor sphincter dyssynergia: A double-blind lidocaine-controlled study in 13 patients with spinal cord disease. Eur. Urol. 2002, 42, 56–62. [Google Scholar] [CrossRef] [PubMed]
- Safari, S.; Jamali, S.; Habibollahi, P.; Arshadi, H.; Nejat, F.; Kajbafzadeh, A.M. Intravesical injections of botulinum toxin type A for management of neuropathic bladder: A comparison of two methods. Urology 2010, 76, 225–230. [Google Scholar] [CrossRef]
- Deshpande, A.V.; Sampang, R.; Smith, G.H. Study of botulinum toxin A in neurogenic bladder due to spina bifida in children. ANZ J. Surg. 2010, 80, 250–253. [Google Scholar] [CrossRef]
- Kuo, H.C. Therapeutic outcome and quality of life between urethral and detrusor botulinum toxin treatment for patients with spinal cord lesions and detrusor sphincter dyssynergia. Int. J. Clin. Pract. 2013, 67, 1044–1049. [Google Scholar] [CrossRef]
- Shaibani, A.; Frisaldi, E.; Benedetti, F. Placebo response in pain, fatigue, and performance: Possible implications for neuromuscular disorders. Muscle Nerve 2017, 56, 358–367. [Google Scholar] [CrossRef]
- Patel, S.M.; Stason, W.B.; Legedza, A.; Ock, S.M.; Kaptchuk, T.J.; Conboy, L.; Canenguez, K.; Park, J.K.; Kelly, E.; Jacobson, E.; et al. The placebo effect in irritable bowel syndrome trials: A meta-analysis. Neurogastroenterol. Motil. 2005, 17, 332–340. [Google Scholar] [CrossRef]
- Hoenemeyer, T.W.; Kaptchuk, T.J.; Mehta, T.S.; Fontaine, K.R. Open-Label Placebo Treatment for Cancer-Related Fatigue: A Randomized-Controlled Clinical Trial. Sci. Rep. 2018, 8, 2784. [Google Scholar] [CrossRef] [Green Version]
- Mostafaei, H.; Janisch, F.; Mori, K.; Quhal, F.; Pradere, B.; Hajebrahimi, S.; Roehrborn, C.G.; Shariat, S.F. Placebo Response in Patients with Oral Therapy for Overactive Bladder: A Systematic Review and Meta-analysis. Eur. Urol. Focus 2022, 8, 239–252. [Google Scholar] [CrossRef]
- Yang, W.H. Yang needle tunneling technique in creating antireflux and continent mechanisms. J. Urol. 1993, 150, 830–834. [Google Scholar] [CrossRef] [PubMed]
- Peters, K.M.; Killinger, K.A.; Ibrahim, I.A.; Villalba, P.S. The relationship between subjective and objective assessments of sacral neuromodulation effectiveness in patients with urgency-frequency. Neurourol. Urodyn. 2008, 27, 775–778. [Google Scholar] [CrossRef] [PubMed]
Median (Range) | |||
---|---|---|---|
Before BoNT-A | After BoNT-A | p Value | |
Compliance (mL/cmH2O) | 8.15 (2.23–340.00) | 11.54 (0.88–75.00) | 0.820 |
Measured/expected CBC (mL/mL) | 0.37 (0.05–1.15) | 0.52 (0.21–1.09) | 0.215 |
Detrusor pressure (cmH2O) | 25 (0–80) | 15 (0–70) | 0.013 |
Post-void residual (mL) | 100 (0–250) | 100 (0–300) | 0.780 |
Neurogenic OAB | Non-Neurogenic OAB | Bladder BoNT-A | Bladder + Urethra BoNT-A | |
---|---|---|---|---|
No. pts | 11 | 4 | 11 | 4 |
Compliance (mL/cmH2O) | ||||
Before BoNT-A | 8.15 (2.23–340.00) | 18.24 (2.40–180.00) | 8.15 (3.08–340.00) | 15.77 (2.23–30.00) |
After BoNT-A | 10.42 (0.88–70.75) | 12.33 (3.27–75.00) | 11.54 (0.88–75.00) | 7.71 (2.11–24.86) |
p Value | 0.461 | 0.343 | 0.316 | 0.283 |
Measured/expected CBC (mL/mL) | ||||
Before BoNT-A | 0.54 (0.05–1.15) | 0.31 (0.22–0.60) | 0.37 (0.05–1.15) | 0.53 (0.22–0.94) |
After BoNT-A | 0.49 (0.25–1.09) | 0.61 (0.21–0.81) | 0.52 (0.21–1.09) | 0.60 (0.34–0.81) |
p Value | 0.694 | 0.238 | 0.215 | 0.903 |
Detrusor pressure (cmH2O) | ||||
Before BoNT-A | 27 (0–61) | 23 (12–80) | 20 (0–61) | 33 (5–80) |
After BoNT-A | 15 (0–41) | 19 (1–70) | 13 (0–41) | 27 (15–70) |
p Value | 0.04 | 0.265 | 0.009 | 0.771 |
Post-void residual (mL) | ||||
Before BoNT-A | 150 (0–250) | 10 (0–210) | 150 (0–250) | 60 (0–150) |
After BoNT-A | 100 (0–300) | 100 (0–300) | 130 (0–300) | 70 (0–200) |
p value | 0.598 | 0.215 | 0.954 | 0.774 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Fan, Y.-H.; Kuo, H.-C. Efficacy of Intravesical Botulinum Toxin A Injection in the Treatment of Refractory Overactive Bladder in Children. J. Pers. Med. 2023, 13, 616. https://doi.org/10.3390/jpm13040616
Fan Y-H, Kuo H-C. Efficacy of Intravesical Botulinum Toxin A Injection in the Treatment of Refractory Overactive Bladder in Children. Journal of Personalized Medicine. 2023; 13(4):616. https://doi.org/10.3390/jpm13040616
Chicago/Turabian StyleFan, Yu-Hua, and Hann-Chorng Kuo. 2023. "Efficacy of Intravesical Botulinum Toxin A Injection in the Treatment of Refractory Overactive Bladder in Children" Journal of Personalized Medicine 13, no. 4: 616. https://doi.org/10.3390/jpm13040616