TY - JOUR
T1 - A simplified technique for botulinum toxin injections in children with neurogenic bladder
AU - Pascali, Maria Paola
AU - Mosiello, Giovanni
AU - Marciano, Armando
AU - Capitanucci, Maria Luisa
AU - Zaccara, Antonio Maria
AU - De Gennaro, Mario
PY - 2011/6
Y1 - 2011/6
N2 - Purpose: Botulinum toxin type A has revolutionized the treatment of neurogenic bladder dysfunction. The original injection technique used a rigid cystoscope and a flexible collagen needle. To date botulinum toxin type A injection techniques have not been standardized. We present our experience in pediatric patients using a new flexible injection system. Materials and Methods: We treated 24 patients 3.8 to 17.5 years old who had neurogenic bladder dysfunction with botulinum toxin type A bladder and/or sphincter injection using a rigid cystoscope and the new N-DO™ endo-injector needle system. Another 24 patients 3.6 to 17.8 years old were treated with a 3.7Fr standard flexible needle and served as controls. Operative time, hospital stay, complications and efficacy were considered. Selection criteria and treatment were the same in the 2 groups. The 10 IU/kg dose was determined according to European Association of Urology guidelines. Results: All patients received botulinum toxin type A bladder injection while 11 patients in the endo-injector group and 5 controls also received urethral injection. In the endo-injector needle and control groups average operative time was 12.4 and 17.3 minutes for the bladder, and 5.1 and 10.1 minutes for the urethra, respectively (each p 2O, and an average bladder capacity increase of 75 and 80 ml in the endo-injector and control groups, respectively (p not significant). Conclusions: While retaining efficacy, the endo-injector needle technique appears to be more rapid than the standard procedure for botulinum toxin type A injection for neurogenic bladder dysfunction. Whether patients may be treated with sedation only remains to be clarified.
AB - Purpose: Botulinum toxin type A has revolutionized the treatment of neurogenic bladder dysfunction. The original injection technique used a rigid cystoscope and a flexible collagen needle. To date botulinum toxin type A injection techniques have not been standardized. We present our experience in pediatric patients using a new flexible injection system. Materials and Methods: We treated 24 patients 3.8 to 17.5 years old who had neurogenic bladder dysfunction with botulinum toxin type A bladder and/or sphincter injection using a rigid cystoscope and the new N-DO™ endo-injector needle system. Another 24 patients 3.6 to 17.8 years old were treated with a 3.7Fr standard flexible needle and served as controls. Operative time, hospital stay, complications and efficacy were considered. Selection criteria and treatment were the same in the 2 groups. The 10 IU/kg dose was determined according to European Association of Urology guidelines. Results: All patients received botulinum toxin type A bladder injection while 11 patients in the endo-injector group and 5 controls also received urethral injection. In the endo-injector needle and control groups average operative time was 12.4 and 17.3 minutes for the bladder, and 5.1 and 10.1 minutes for the urethra, respectively (each p 2O, and an average bladder capacity increase of 75 and 80 ml in the endo-injector and control groups, respectively (p not significant). Conclusions: While retaining efficacy, the endo-injector needle technique appears to be more rapid than the standard procedure for botulinum toxin type A injection for neurogenic bladder dysfunction. Whether patients may be treated with sedation only remains to be clarified.
KW - botulinum toxin type A
KW - endoscopy
KW - injections
KW - urethra
KW - urinary bladder neurogenic
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U2 - 10.1016/j.juro.2011.01.037
DO - 10.1016/j.juro.2011.01.037
M3 - Article
C2 - 21527204
AN - SCOPUS:79955824941
VL - 185
SP - 2558
EP - 2562
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 6 SUPPL.
ER -