Onabotulinum toxin A in children with refractory idiopathic overactive bladder: medium-term outcomes

Ingham, Jack; Angotti, Rossella; Lewis, Malcolm; Goyal, Anju

doi:10.1016/j.jpurol.2018.08.007

Cited by 16 publications

(17 citation statements)

References 12 publications

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“…For recurrence of symptoms after BtA, the options are to consider either repeat BtA or anticholinergics. Ingham et al (14) reported that 92% of children have recurrence of OAB symptoms after initial BtA and 44% require repeat BtA. In our experience, complete long-term resolution after single BtA is rare.…”

Section: Exit Strategy After Bta Treatmentmentioning

confidence: 49%

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Mirabegron in Overactive Bladder and Its Role in Exit Strategy After Botulinum Toxin Treatment in Children

2022

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PurposeMirabegron is a recent addition to the management options of overactive bladder (OAB) in children. The purpose of this study was to ascertain the role of Mirabegron in the treatment algorithm of therapy-resistant OAB especially after botulinum toxin.MethodsCase notes of all children receiving Mirabegron between July 2017 and February 2020 were reviewed.ResultsForty one children (21 females, 20 males), mean age 12.6 [8–17] years old, commenced Mirabegron: 35 idiopathic OAB, 6 neuropathic OAB. The mean duration of treatment was 20.7 [3–45] months. In total 24 (59%) had Mirabegron after partial/no response to anticholinergics, and 17 (41%) patients had Mirabegron subsequent to botulinum toxin A (BtA) as an exit strategy. In total 35 (85%) patients had combination therapy (Mirabegron and anticholinergics), and 6 (15%) patients had Mirabegron only. Fourteen (34%) had complete response, 17 (41%) had partial response, and 10 (24%) had no response. Side effects were reported in 7 (17%) patients with discontinuation necessitated in 3.ConclusionMirabegron when used alone or in combination with anticholinergics resulted in complete/partial response in 76% of anticholinergic therapy-resistant OAB. In addition to being an important step in treatment escalation after no/partial response to anticholinergics, it has a crucial role in the exit strategy for recurring symptoms after BtA wears off.

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Section: Exit Strategy After Bta Treatmentmentioning

confidence: 49%

“…Of these, 7 had complete response, 8 had PR, and 2 had no response (1 discontinued due to side effects). Only 4 (24%) of the 17 children required repeat BtA as opposed to 44% reported in other studies (14). The BtA treatment dose for children 5 units per kg, maximum of 150 units first time.…”

Section: Exit Strategy After Bta Treatmentmentioning

confidence: 76%

Mirabegron in Overactive Bladder and Its Role in Exit Strategy After Botulinum Toxin Treatment in Children

2022

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“…Ingham et al [13] also showed an increase in total bladder volume. Though in this study, as a result of concomitant rise in PVR, they found no improvement in FBV.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 89%

Intravesical botulinum-A toxin in children with refractory non-neurogenic overactive bladder

Lambregts

Nieuwhof-Leppink

Klijn

et al. 2022

Journal of Pediatric Urology

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“…Costs are given in Canadian dollars, using Canadian public health system, and based on our institutional experience and available literature. The costs do not include physicians time, follow up appointments, ongoing costs into adulthood (30,31), nor the time required daily for personal care (>1 h/day). The costs indicated here include the initial surgery/set up and supplies for 3-5 years.…”

Section: Cost Analysismentioning

confidence: 99%

Assessment of Needs in Children Suffering From Refractory Non-neurogenic Urinary and Fecal Incontinence and Their Caregivers' Needs and Attitudes Toward Alternative Therapies (SNM, TENS)

et al. 2020

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Background: Non-neurogenic urinary and fecal incontinence (UI, FI) affects approximately 6% of North American children with 1% of cases becoming refractory (nonresponsive to standard therapies). Incontinence has major potential long-term physiological and psychological implications for patients and their families. While Sacral Neuromodulation (SNM) and Transcutaneous Nerve Stimulation (TENS) are alternative therapies available for the treatment of refractory UI/FI, these are not approved for use in children in Canada. The present study assessed participants' perception of current treatments, incontinence burden, and attitudes toward novel therapies in a single pediatric institution. Methods: Multiple validated questionnaires including Dysfunctional Voiding Scoring System (DVSS), Bristol Stool Chart (BSC), Pediatric Incontinence measurement (PinQ), and Time-Driven Activity Based Costing were used to perform a needs assessment for patients with non-neurogenic refractory incontinence, and to determine patients' and caregivers' attitudes toward alternative therapies. Results: 75% of patients and 89% of caregivers reported a moderate to severe impact of incontinence on QoL with diminished social interactions among the primary concerns. Caregivers were frustrated with current treatments and were open to trying alternative therapies (SNM and TENS), which, at least in the case of SNM, seems to be less expensive, possibly less burdensome and more effective than current surgical options. Dos Santos et al. Pediatric Incontinence Burden Conclusion: Pediatric refractory UI/FI has a large impact on patients' and caregivers' QoL and alternative therapies with the potential to improve QoL of patients and caregivers should be further investigated as a substitute for surgery.

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Onabotulinum toxin A in children with refractory idiopathic overactive bladder: medium-term outcomes

Cited by 16 publications

References 12 publications

Mirabegron in Overactive Bladder and Its Role in Exit Strategy After Botulinum Toxin Treatment in Children

Mirabegron in Overactive Bladder and Its Role in Exit Strategy After Botulinum Toxin Treatment in Children

Intravesical botulinum-A toxin in children with refractory non-neurogenic overactive bladder

Assessment of Needs in Children Suffering From Refractory Non-neurogenic Urinary and Fecal Incontinence and Their Caregivers' Needs and Attitudes Toward Alternative Therapies (SNM, TENS)

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