Effect of Botox injection at the bladder neck in boys with bladder dysfunction after valve ablation

Mokhless, Ibrahim; Zahran, Abdelrahman; Saad, Ashraf; Yehia, Mohamed; Youssif, Mohamed

doi:10.1016/j.jpurol.2013.12.023

Cited by 17 publications

(6 citation statements)

References 10 publications

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“…28 Patients with hyper-reflexic and small, poorly compliant bladders are primarily treated with oral anticholinergics, alpha agonists, and/or intravesical onabotulinumtoxi-nA. [29][30][31] Polyuria, defined as hypo-osmolar urine output at a volume >30 cc/kg/day, can further exacerbate bladder dysfunction. 32 Polyuria may be treated with overnight catheterization, or nephrectomy for non-functional kidneys.…”

Section: Bladder Dysfunctionmentioning

confidence: 99%

“…34,35 Failure in any of these groups will lead to a need for surgical intervention ranging from intradetrusor onabotulinumtoxinA to augmentation cystoplasty with creation of a catheterizable channel. 30,36 When evaluating a young adult with a history of PUV, it is important to keep in mind that residual bladder symptoms are likely due to detrusor areflexia. 37,38 Incontinence generally resolves by young adulthood, perhaps due to the growth of the prostate.…”

Section: Bladder Dysfunctionmentioning

confidence: 99%

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All grown up: A transitional care perspective on the patient with posterior urethral valves

Keays

McAlpine

Welk

2018

CUAJ

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Section: Bladder Dysfunctionmentioning

confidence: 99%

Section: Bladder Dysfunctionmentioning

confidence: 99%

All grown up: A transitional care perspective on the patient with posterior urethral valves

Keays

McAlpine

Welk

2018

CUAJ

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“…The effect is reported to last between 2 and 12 months. [70] In a study of Mokhless, endoscopic injection of a dose of 100 IU of Botox into the hypertrophied bladder neck does not improve the outcome of boys with voiding dysfunction after valve ablation [71].…”

Section: Effects Of Btx Detrusor Injectionmentioning

confidence: 98%

The Current Role of Botox in a Pediatric Neurogenic Bladder Condition

Kroll

2019

Curr Bladder Dysfunct Rep

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Purpose of Review The neurogenic bladder is a medical term that describes a variety of bladder and sphincter dysfunctions. There are two major dangerous functional problems in a child with neurogenic bladder: high intravesical pressure in the storage phase and high pressure during urination. Two basic goals for urologic treatment in those children are protection of urinary tract from complications and improvement of continence in older children. This review focuses on the current role of botulinum toxin treatment in children with neurogenic bladder. Recent Findings At the beginning, treatment in this group of children is conservative. Oral anticholinergic therapy is aimed at decreasing bladder pressures during the storage phase. Clean intermittent catheterization enables bladder emptying if voiding is insufficient. Nevertheless, in a number of children such an approach fails, in some patients, troublesome side effects occur. In cases when standard therapy provides no improvement or if complications develop on the proper conservative treatment, surgical procedures are suggested. Operations are aimed at the surgical enlargement of bladder capacity. There are some reports on the efficacy of cystoscopic detrusor botulinum toxin injections in the treatment of neurogenic bladder in children. Summary Cystoscopic administration of botulinum toxin represents an alternative method of treatment to surgery for children with neurogenic bladder and could be considered an alternative to oral anticholinergic therapy.

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“…There is a general consensus that in boys with posterior urethral valves bladder neck must be evaluated and treated to enable optimal bladder emptying on the long term (29). Alpha 1 -blockers, bladder neck incision, and botulinum toxin type A injection into the bladder neck have been reported as treatment options for this condition, but no randomized trials are available (30–32). …”

Section: Bladder Neck and Lutsmentioning

confidence: 99%

Refractory Urinary Incontinence in Girls: The Role of the Bladder Neck

Chrzan

2017

Front. Pediatr.

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BackgroundPrevalence of lower urinary tract dysfunction (LUTD) in children is between 6 and 9% with urinary incontinence (UI) being one of the most common symptom.Various aspects of lower urinary tract symptoms (LUTS)Anatomical anomalies of the urinary tract as well as neurogenic underlying pathology can results in LUTS. Comorbidities and long-term consequences of the LUTD for the female patients as well as genetic issues are also briefly discussed.The role of the bladder neckThanks to urodynamics, we have learnt a lot about the lower urinary tract function, but the role of the bladder neck in the pathophysiology of LUTS in children is not clear. Secondary bladder neck hypertrophy is a well-described pathology, but there is no standardized treatment for this phenomenon. Primary bladder neck dysfunction has already been defined by the International Children’s Continence Society.Refractory UI in girlsUniform diagnostic protocols are used in these girls with UI. Treatment consists of standard urotherapy, additional interventions, and pharmacotherapy in selected cases. Those with refractory UI require careful reassessment to look for the unrecognized disorders. Invasive urodynamics should be done in those patients. Ultrasound of the bladder neck region and the pelvic floor can be helpful, but its interpretation is very subjective. In a small group bladder neck insufficiency can be found and those might benefit from a surgical intervention.Future perspectiveStrict criteria of the bladder neck insufficiency in children must be defined. Early surgical intervention in girls with bladder neck insufficiency might reduce the long period of intensive conservative treatment.

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Effect of Botox injection at the bladder neck in boys with bladder dysfunction after valve ablation

Cited by 17 publications

References 10 publications

All grown up: A transitional care perspective on the patient with posterior urethral valves

All grown up: A transitional care perspective on the patient with posterior urethral valves

The Current Role of Botox in a Pediatric Neurogenic Bladder Condition

Refractory Urinary Incontinence in Girls: The Role of the Bladder Neck

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