Fan Yu-Hua, Kuo Hann-Chorng
Department of Urology, Taipei Veterans General Hospital, Taipei 112, Taiwan.
Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
J Pers Med. 2023 Mar 31;13(4):616. doi: 10.3390/jpm13040616.
This study aimed to evaluate the efficacy of intravesical botulinum toxin A (BoNT-A) injections for the treatment of pediatric overactive bladder (OAB) by exploring the differential treatment outcomes in children with different OAB etiologies and those who received additional intrasphincteric BoNT-A injections. We performed a retrospective review of all pediatric patients who received intravesical BoNT-A injections between January 2002 and December 2021. All patients underwent a urodynamic study at baseline and three months after BoNT-A administration. A Global Response Assessment (GRA) score of ≥2 at three months after BoNT-A injection was defined as successful treatment. Fifteen pediatric patients (median age, 11 years), including six boys and nine girls, were enrolled in the study. A statistically significant decrease in detrusor pressure from baseline to three months postoperatively was observed. Thirteen (86.7%) patients reported successful results (GRA ≥ 2). The cause of OAB and additional intrasphincteric BoNT-A injections did not affect the improvement in urodynamic parameters and treatment success. The study demonstrated that intravesical BoNT-A injection is effective and safe for the treatment of neurogenic and non-neurogenic OAB in children refractory to conventional therapies. Additionally, intrasphincteric BoNT-A injections do not provide additional benefits in the treatment of pediatric OAB.
本研究旨在通过探讨不同病因的小儿膀胱过度活动症（OAB）患儿以及接受额外膀胱括约肌内注射A型肉毒毒素（BoNT-A）的患儿的不同治疗结果，评估膀胱内注射BoNT-A治疗小儿OAB的疗效。我们对2002年1月至2021年12月期间接受膀胱内注射BoNT-A的所有儿科患者进行了回顾性研究。所有患者在基线时以及注射BoNT-A后三个月接受了尿动力学检查。BoNT-A注射后三个月时全球反应评估（GRA）评分≥2被定义为治疗成功。15名儿科患者（中位年龄11岁），包括6名男孩和9名女孩，纳入了本研究。观察到从基线到术后三个月逼尿肌压力有统计学意义的下降。13名（86.7%）患者报告治疗成功（GRA≥2）。OAB的病因和额外的膀胱括约肌内注射BoNT-A并不影响尿动力学参数的改善和治疗成功率。该研究表明，膀胱内注射BoNT-A对于传统疗法难治的小儿神经源性和非神经源性OAB的治疗是有效且安全的。此外，膀胱括约肌内注射BoNT-A在小儿OAB的治疗中并无额外益处。
