Intravesical injections of botulinum toxin A for the treatment of refractory urinary frequency and incontinence in 35 children
10.3760/cma.j.cn101070-20241017-00669
- VernacularTitle:A型肉毒毒素膀胱壁注射治疗儿童难治性尿频尿失禁35例
- Author:
Zhan WANG
1
;
Yibo WEN
;
Zhaokai ZHOU
;
Shuai YANG
;
Lei LYU
;
Yanping ZHANG
;
Qi LI
;
Qingwei WANG
;
Wen ZHU
;
Guoxian ZHANG
;
Yakai LIU
;
Huiqing ZHANG
;
Jianguo WEN
Author Information
1. 郑州大学第一附属医院泌尿外科小儿尿动力中心，河南省小儿尿动力国际联合实验室，郑州 450052
- Publication Type:Journal Article
- Keywords:
Child;
Urinary frequency;
Urinary incontinence;
Botulinum toxin A;
Urodynamic study;
Prognostic factor
- From:
Chinese Journal of Applied Clinical Pediatrics
2025;40(7):521-525
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.
