کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3905872 1250415 2006 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Intravesical injection of botulinum toxin type A: Management of neuropathic bladder and bowel dysfunction in children with myelomeningocele
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
پیش نمایش صفحه اول مقاله
Intravesical injection of botulinum toxin type A: Management of neuropathic bladder and bowel dysfunction in children with myelomeningocele
چکیده انگلیسی

ObjectivesTo evaluate the efficacy of botulinum toxin A in the treatment of children with detrusor hyperreflexia caused by myelomeningocele and the effects of this treatment on neuropathic bladder and bowel dysfunction.MethodsIn a prospective study, 26 children with myelomeningocele (20 boys and 6 girls, mean age 6.9 years) were included. All patients had been nonresponders to medical treatment and required clean intermittent catheterization. Under cystoscopic guidance, 10 IU/kg of botulinum toxin A was injected into the detrusor muscle, sparing the trigone and ureteral orifices. In each patient, urinary incontinence grade and improvement in parameters of interest in the evaluation of bowel dysfunction were assessed before and 4 months after injection. Conventional urodynamic studies to determine maximal bladder capacity and maximal detrusor pressure and voiding cystoureterography were also performed.ResultsFour months after procedure, 19 patients (73%) had become completely dry between clean intermittent catheterizations, and the total improvement in urine incontinence was 88%. The mean maximal detrusor pressure was decreased to 83.2 ± 4.6 cm H2O from the baseline of 139.3 ± 11.2 (P <0.01). The average maximal bladder capacity increased from 102.8 ± 6.3 mL to 270.2 ± 9.5 mL (P <0.01). Of the 15 patients who had varying degrees of vesicoureteral reflux before the procedure, 11 (73%) had decrease in the vesicoureteral reflux grade. Also, bowel dysfunction improved in 10 (66%) of the 15 patients.ConclusionsBotulinum toxin A appears to be a safe, minimally invasive procedure for the management of neuropathic bladder and bowel dysfunction in children with myelomeningocele.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Urology - Volume 68, Issue 5, November 2006, Pages 1091–1096
نویسندگان
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