DasGupta Ranan, Murphy Feilim Liam
Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
Pediatr Surg Int. 2009 Jan;25(1):19-23. doi: 10.1007/s00383-008-2260-3. Epub 2008 Oct 25.
The use of botulinum toxin in paediatric urology has become increasingly widespread during recent years; however, the evidence base for its clinical use has been from adult urology centres and trials. The mechanism of action of this potent neurotoxin is discussed and evidence for its efficacy and safety is reviewed in both the adult and paediatric literature. Second, an electronic literature search was performed using the keywords paediatric urology, botulinum toxin, bladder, sphincter, and voiding dysfunction (excluding abstracts, letters and case reports). A total of 225 children in 10 peer-reviewed publications were evaluated with 165 paediatric patients with neurogenic overactivity (6 studies), 21 patients with idiopathic overactivity (1 study) and 39 patients with voiding dysfunction (3 studies). Specifically, we discuss the main indications of intravesical injections for detrusor overactivity and of intrasphincteric injections for refractory voiding dysfunctions in the paediatric population.
近年来，肉毒杆菌毒素在小儿泌尿外科的应用越来越广泛；然而，其临床应用的证据基础来自成人泌尿外科中心和试验。本文讨论了这种强效神经毒素的作用机制，并在成人和儿科文献中综述了其有效性和安全性的证据。其次，使用关键词“小儿泌尿外科”“肉毒杆菌毒素”“膀胱”“括约肌”和“排尿功能障碍”进行电子文献检索（不包括摘要、信函和病例报告）。10篇同行评议出版物中共评估了225名儿童，其中165名患有神经源性膀胱活动亢进的儿科患者（6项研究），21名患有特发性膀胱活动亢进的患者（1项研究），39名患有排尿功能障碍的患者（3项研究）。具体而言，我们讨论了小儿人群中膀胱内注射治疗逼尿肌过度活动的主要适应症以及括约肌内注射治疗难治性排尿功能障碍的主要适应症。
