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Objective and subjective improvement in children with idiopathic detrusor overactivity after intravesical botulinum toxin injection: A preliminary report
Authors:Ghazi M. Al Edwan  Hammam H. Mansi  Omar Nabeeh M. Atta  Mohammad M. Shaath  Rawand Al Adwan  Waleed Mahafza  Kameel M. Afram  Omar Ababneh  Deema Al Adwan  Muheilan M. Muheilan
Affiliation:1. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan;2. School of Medicine, The University of Jordan;3. Department of Obstetrics and Gynecology, Jordan University Hospital, The University of Jordan;4. Department of Radiology, Jordan University Hospital, The University of Jordan;5. Department of Anesthesiology, Jordan University Hospital, The University of Jordan
Abstract:

Objective

The purpose of this study is to evaluate the effect of Intravesical Botulinum toxin injection on the symptoms and urodynamic parameters in pediatric patients with idiopathic overactive bladder (iOAB) refractory to medical treatment.

Materials and methods

The study was designed as an open-label uncontrolled therapeutic clinical trial. The eligible patients who underwent Intravesical botulinum toxin injection were evaluated before treatment. The evaluation included a 7-day paper bladder diary to assess OAB symptoms (frequency, urgency urinary incontinence (UUI) and nocturnal enuresis (NE)), filling the Arabic International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI short form), and conducting urodynamic study. The Urodynamic parameters obtained were the maximum filling detrusor pressure, cystometric bladder capacity, and compliance. After 12?weeks of the intravesical injection, the patients were revaluated and the results were compared using paired samples t-test.

Results

The study enrolled 75 patients. And of those, statistical analysis was done on 46 patients who did follow the study protocols. The mean age was 8.9?years and male to female ratio was 1:4. There was a statistically significant improvement in overactive bladder symptoms and urodynamic parameters in the patient injected with botulinum toxin with minimal side effects.

Conclusion

The evidence in this study would support the safety and efficacy of Intravesical botulinum toxin injection in children with refractory idiopathic OAB with significant improvement of symptoms, quality of life, as well as urodynamic parameters.

Type of Study

Open-label uncontrolled therapeutic clinical trial.

Level of Evidence

III
Keywords:Idiopathic detrusor overactivity  Intravesical botulinum toxin injection  Overactive bladder
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