%0 Journal Article
%T Es la inyecci¨®n de Toxina botul¨ªnica-A en el detrusor una alternativa a la ampliaci¨®n vesical en ni£¿os
%A Romero
%A R.M.
%A Rivas
%A S.
%A Parente
%A A.
%A Fanjul
%A M.
%A Angulo
%A J.M.
%J Actas Urol¨®gicas Espa£¿olas
%D 2011
%I Scientific Electronic Library Online
%R 10.4321/S0210-48062011000200006
%X introduction: bladder dysfunction causes urinary incontinence and kidney damage in children. when treatment with anticholinergics and intermittent bladder catheterization fails, the alternative therapy is bladder augmentation. patients and methods: between 2005 and 2009, a prospective study was carried out with botox£¿ injected into the detrusor of children suffering from high-pressure bladder despite anticholinergic treatment. we assessed their urodynamic, clinical and radiological evolution prior to and at 4 weeks, 6 months and 1 year after the injection (10 u/kg of weight up to 300 u). reinjection was indicated in the event of clinical or urodynamic worsening. we employed the wilcoxom test to statistically analyze the urodynamic parameters. results: 12 patients were treated, 11 with neurogenic bladder (91.7%) and 1 with posterior urethral valves (8.4%). the mean age was 12.6 (4.3-17.8) years and follow-up took place after 40.8 (16.9-45-7) months. bladder capacity, detrusor accommodation and pressure improved after 4 weeks in all the patients except in 2 (16.7%). this improvement decreased after 6 months, although successive injections produced similar changes. one patient (8.3%) received 1 dose, six (50%) two doses and five (41.7%) received three. clinical and urodynamic improvement in 8 patients (66.7%) prevented bladder augmentation. conclusions: repeated botulinum toxin injection in the detrusor is a therapeutic instrument for high pressure and low accommodation bladders in children. it could replace bladder augmentation in some cases, however further studies with long-term follow-up care are required to appropriately evaluate its safety and effectiveness.
%K neurogenic bladder dysfunction
%K non-neurogenic bladder dysfunction
%K urinary incontinence
%K bladder augmentation
%K botulinum toxin.
%U http://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S0210-48062011000200006&lng=en&nrm=iso&tlng=en