Urine markers and bladder wall thickness measurement may predict urinary tract impairment in children with myelodysplasia. Such markers may differentiate at risk patients with either renal scarring or high detrusor leak point pressure, and decrease the need for urodynamics and renal scintigraphy.

This preliminary study, suggests urinary TGF-Beta-1 and NGF as a potent marker in children with NDOA, as they decline following BoNT-A injection. Further studies are needed in identifying their special role in assessing treatment success after invasive interventions.

Present study showed that more than half of the children with myelodysplasia had normal UUT function even with a DLPP of 40 cm H O and over. Thus, DLPP, is not the sole decision making parameter to rely for more invasive therapies in children with myelodysplasia. On the other hand, a DLPP cut-off value of 20 cm H O showed a higher sensitivity to predict UUT damage instead of 40 cm H O. Neurourol. Urodynam. 36:759-763, 2017. © 2016 Wiley Periodicals, Inc.

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PurposeThis was a prospective single-arm study to assess the efficacy and safety of intradetrusor injections of onabotulinum toxin-A in children with urinary incontinence associated with neurogenic detrusor overactivity due to myelomeningocele. All patients had failed the first-line treatment of a combination of oral antimuscarinics and intermittent catheterization.Materials and MethodsThe study group consisted of 31 children with myelomeningocele with a mean age of 7.95 years (range, 5-3 years) who were followed up for a mean of 29 weeks. The amount of onabotulinum toxin A injected was 10 U/kg with a maximal dose of 300 U. There were 20 to 30 injection sites with rigid cystoscopic guidance under general anesthesia.ResultsThirty of 31 patients reported dryness between intermittent catheterization intervals. The mean reduction in maximum detrusor pressure and the mean increase in maximum cystometric capacity from baseline were 53% and 51.5%, respectively, 6 weeks after injection. We found a 324% increase in mean bladder compliance and a 57% increase in mean intermittent catheterization volumes. The mean duration of efficacy was 28 weeks with a single injection and 36 weeks for repeated injections (minimum, 16 weeks; maximum, 52 weeks). The mean time interval between repeated onabotulinum toxin-A injections was 7 months (maximum, 13 months). Intradetrusor injections of onabotulinum toxin-A were well tolerated.ConclusionsOnabotulinum toxin-A injections into the bladder wall provide a significant symptomatic and urodynamic improvement in children with neurogenic detrusor overactivity due to myelomeningocele who are on intermittent catheterization. The treatment seems to be safe and very well tolerated.

Erectile dysfunction (ED) and diabetes mellitus (DM) are common health problems that have a significant effect on quality of life. DM is one of the leading risk factors for ED. Men with DM present with refractory and more severe ED than nondiabetic men (Walle, Lebeta, Fita, & Abdissa, 2018). Diabetic ED has a multifactorial aetiology. It can be caused by any alteration in vascular, neural, hormonal and cavernosal tissue consistency (Thorve et al., 2011). Hyperglycemia in diabetes will finally generate reactive oxygen species (ROS) resulting in endothelial cell damage and neuropathy with the formation of advanced glycation end-products (AGEs;