Hsu Chun-Kai, Lin Han-Yu, Yang Stephen Shei-Dei, Young Wan-Ling, Wu Shu-Yu
Department of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231016, Taiwan.
School of Medicine, Tzu Chi University, Hualien 97004, Taiwan.
Toxins (Basel). 2025 Apr 17;17(4):202. doi: 10.3390/toxins17040202.
Neurogenic detrusor overactivity (NDO) is a complex condition associated with detrusor overactivity, reduced bladder compliance, and high intravesical pressures, potentially leading to urinary tract infections (UTIs) and renal impairment. This retrospective study evaluated the safety and potential efficacy of intravesical botulinum toxin A (BoNT/A) injections in children with NDO at a single institution. Eighteen pediatric patients (median age: 8.1 years) were followed for a median of 6.3 years. At follow-up, 77.8% achieved a global response assessment (GRA) score of ≥2. A statistically significant improvement was found in cystometric bladder capacity ( = 0.041), but it did not remain significant after Bonferroni correction, while other urodynamic trends were not statistically significant. Adverse events were infrequent, with only 11.8% experiencing mild febrile UTIs. While some patients with poorer baseline bladder conditions reported greater subjective improvement, no statistically significant predictors of success were identified. Overall, intravesical BoNT/A injection appears to be a safe and potentially effective option for managing pediatric NDO, though larger prospective studies are needed to confirm these findings.
神经源性逼尿肌过度活动症（NDO）是一种复杂的病症，与逼尿肌过度活动、膀胱顺应性降低及膀胱内高压相关，可能导致尿路感染（UTIs）和肾功能损害。这项回顾性研究评估了在单一机构中，膀胱内注射A型肉毒杆菌毒素（BoNT/A）对患有NDO的儿童的安全性和潜在疗效。18名儿科患者（中位年龄：8.1岁）接受了中位时间为6.3年的随访。随访时，77.8%的患者获得了≥2的整体反应评估（GRA）评分。膀胱测压容量有统计学意义的改善（P = 0.041），但在Bonferroni校正后不再显著，而其他尿动力学趋势无统计学意义。不良事件发生率低，仅有11.8%的患者出现轻度发热性UTIs。虽然一些基线膀胱状况较差的患者报告主观改善更大，但未发现有统计学意义的成功预测因素。总体而言，膀胱内注射BoNT/A似乎是治疗儿童NDO的一种安全且可能有效的选择，不过需要更大规模的前瞻性研究来证实这些发现。
