Szwarcberg Eliza, Kimber Chris, Taghavi Kiarash
Department of Paediatric Urology, Monash Children's Hospital, 246 Clayton Rd, Clayton, Melbourne, VIC, 3168, Australia.
Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
Pediatr Surg Int. 2025 Jul 10;41(1):204. doi: 10.1007/s00383-025-06106-7.
Intravesical Botox injection can be effective in children with functional urinary incontinence refractory to conservative measures. A wide range of potential doses have been reported with concerns regarding the safety of higher doses. This study aims to determine the safety and side effect profile of 200iU of Botox in children of all ages with functional urinary incontinence.
A retrospective review of 143 children who received 200iU of botulinum toxin A utilising intradetrusor injections was performed. All children had urinary incontinence with no defined neurological abnormality. Post-operative complications were analysed, including UTI, adverse drug reactions, pain, haematuria, urinary retention, transitory increased incontinence and systemic adverse effects.
A total of 228 injection procedures (range: 1-6 procedures) in 143 children (70 girls, 73 boys) were included. Median age at first treatment was 9 years (range: 4-17 years). The mean number of treatment cycles required per patient was 1.59 (range: 1-6). There were no intra-operative complications. Post-operative complications included UTI, post-operative pain and haematuria. No complication required re-admission and no cases of urinary retention requiring catheterisation occurred.
This study represents the largest population to date of children with functional urinary incontinence treated with intravesical Botox, confirming this as a well-tolerated, safe intervention in all ages with complications as would be expected for cystoscopy alone.
膀胱内注射肉毒杆菌毒素对保守治疗无效的功能性尿失禁儿童可能有效。已报道了广泛的潜在剂量，但对高剂量的安全性存在担忧。本研究旨在确定200国际单位肉毒杆菌毒素对所有年龄段功能性尿失禁儿童的安全性和副作用情况。
对143例接受200国际单位肉毒杆菌毒素A逼尿肌内注射的儿童进行回顾性研究。所有儿童均有尿失禁且无明确神经异常。分析术后并发症，包括尿路感染、药物不良反应、疼痛、血尿、尿潴留、暂时性尿失禁加重和全身不良反应。
共纳入143例儿童（70例女孩，73例男孩）的228次注射操作（范围：1 - 6次操作）。首次治疗时的中位年龄为9岁（范围：4 - 17岁）。每位患者所需治疗周期的平均次数为1.59次（范围：1 - 6次）。术中无并发症。术后并发症包括尿路感染、术后疼痛和血尿。无并发症需要再次入院，也未发生需要导尿的尿潴留病例。
本研究是迄今为止接受膀胱内注射肉毒杆菌毒素治疗的功能性尿失禁儿童的最大样本量研究，证实这是一种各年龄段耐受性良好、安全的干预措施，其并发症与单纯膀胱镜检查预期的并发症相同。
