The news reporters obtained a quote from the research from the University of Naples, "They presented overactive/poor compliant neurogenic bladders on clean intermittent catheterization, and were resistant or non compliant to pharmacological therapy. Ten patients presented second to fourth grade concomitant monolateral/bilateral vesicoureteral reflux (VUR). All patients were incontinent despite catheterization. In the majority of patients Botulinum-A toxin was administered under general/local anesthesia by the injection of 200 IU of toxin, without exceeding the dosage of 12IU/kg body weight, diluted in 20 cc of saline solution in 20 sites, except in the periureteral areas. Follow-up included clinical and ultrasound examination, urodynamics performed at 6, 12 and 24 weeks, and annually thereafter. Seven patients remained stable, 21 patients required a second injection after 6-9 months and 19 a third injection. VUR was corrected, when necessary, in the same session after the BT-A injection, by 1-3 cc of subureteral Deflux®. Urodynamic parameters considered were leak point pressure (LPP), leak point volume (LPV) and specific volume at 20 cm H(2)O pressure. The results were analyzed using the Wilcoxon test. All patients experienced a significant 66.45% average increase of LPV (Wilcoxon paired rank test=7169 x 10 -10) and a significant 118.57% average increase of SC 20 (Wilcoxon paired rank test=2.466 x 10 -12). The difference between preoperative and postoperative LPP resulted not significant (Wilcoxon paired rank test=0.8858) No patient presented severe systemic complications; 38/47 patients presented slight hematuria for 2-3 days. Two patients had postoperative urinary tract infection. All patients were hospitalized for 24 h with catheterization. Thirty-eight out of 47 patients achieved dryness between CIC; nine patients improved their incontinence but still need pads. Ten patients have resumed anticholinergic agents."
According to the news reporters, the research concluded: "Our results suggest that the use of BTX-A is safe and effective in patients with MMC with a positive effect on their dryness and quality of life."
For more information on this research see: Onabotulinumtoxin a for treating overactive/poor compliant bladders in children and adolescents with neurogenic bladder secondary to myelomeningocele. Toxins, 2012;5(1):16-24.
Our news correspondents report that additional information may be obtained by contacting A. Marte, Pediatric Surgery 2nd University of Naples, Via Pansini 5, Naples 80131, Italy.
Keywords for this news article include: Italy, Naples, Europe, Therapy, Pediatrics, Catheterization, Neurogenic Bladder.
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