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Abobotulinum toxin A injection improves outcomes in paediatric patients with neurogenic bladder

06 Feb 2020

Paediatric patients with neurogenic bladder may benefit from intradetrusor abobotulinum toxin A, which has been shown to improve cystometric capacity and maximum neurogenic detrusor overactivity in a recent study. This effect persists over multiple injections.

Additionally, “[c]ompliance is significantly improved in patients with low compliance bladder vs overactive bladder,” the authors said.

Of the 30 patients included in this study, 15 (50 percent) received multiple abobotulinum toxin A injections. Sixteen patients (53 patients) had an overactive bladder.

Administration of abobotulinum toxin A led to significant improvements in cystometric capacity (p<0.0001) and maximum neurogenic detrusor overactivity (p=0.0001). No significant change was observed in compliance overall (p=0.25). Urodynamic parameters did not significantly differ between first and last abobotulinum toxin A injections.

Improvement was comparable between the low compliance and overactive bladder groups in terms of cystometric capacity (p=0.05) and maximum neurogenic detrusor overactivity (p=0.25). Moreover, compliance significantly improved in the low compliance group compared with the overactive bladder group (p=0.016).

In this study, the authors carried out a single-centre retrospective review of paediatric patients with neurogenic bladder treated with abobotulinum toxin A. They collected videourodynamic data on cystometric capacity, maximum neurogenic detrusor overactivity pressure and compliance before and after the first abobotulinum toxin A administration and after the last administration.

Patients were then divided into low compliance and overactive bladder groups based on initial videourodynamic findings. Videourodynamic outcomes before and after abobotulinum A injections were compared using paired t-test. Bladder groups were compared using the Mann-Whitney U test.

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