INTRODUCTION: Botulinum toxin injection (BTI) has been advocated as a second line therapy in management of @entity1973 in pediatric population for refractory @entity1 to conventional medical management such as anticholinergics. The purpose was to review the safety and efficacy of BTI in @entity1 with @entity1973 refractory to conservative non-surgical measures. We hypothesized that BTI would be an effective alternative to @entity1494 in certain @entity1 but not all. METHODS: We retrospectively identified 22 @entity1 with @entity1973 due to any condition who underwent urologic BTI at our hospital since 2010. Multiple clinicopathologic variables were examined including the following: demographics, use of anticholinergics, the presence of anticholinergic refractoriness or intolerance, dosage of BTI, urodynamic variables, and continence status. RESULTS: The mean @entity1 age at time of BTI was 10 years with a follow up of 12 months. Indications for BTI were @entity27081 ( @entity27081 ) urodynamic parameters and/or @entity322 and @entity46057 ( @entity46057 ). Nearly all @entity1 received 300 Units at BTI into detrusor. No complications occurred from BTI. Overall 54% had improved continence after the initial BTI whereas 45% had achieved complete continence between catheterizations. Cystometric capacity increased by 46% and maximum detrusor pressure decreased by 43% following initial BTI (See Table). 75% of @entity46057 @entity1 were continent between CIC after BTI compared to 50% of @entity27081 @entity1 (P  =  0.002). The observed mean duration of clinical improvement after initial BTI was 4.6 months and four @entity1 underwent repeat BTI. Pre BTI % of age expected bladder capacity Post BTI % of age expected bladder capacity % Improvement in Urodynamic Parameter P value Cystometric Capacity (mL) 227 60 331 87 46 0.008 Maximum Detrusor Pressure (cm @entity4358 ) 63 44 43 0.002 Compliance (mL/cm @entity4358 ) 4.3 8.8 104 0.001. DISCUSSION: Our results are comparable to existing literature with respect to urodynamic parameters. The observed differences may be due to heterogenous @entity1 population of various etiologies of @entity1973 and no uniform criteria to proceed with @entity1494 . The @entity27081 @entity1 in our cohort may have had a higher degree of @entity1494 which BTI would be less likely to impact and explain the differences in clinical response between @entity27081 and @entity46057 @entity1 . CONCLUSIONS: BTI is a safe and effective treatment option for pediatric @entity1 with @entity1973 refractory to standard therapy. The degree of continence observed after BTI in our series was higher for @entity46057 rather than @entity27081 @entity1 .

Botulinum toxin injection in the pediatric population with medically refractory XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity322 :: ('MESH:D014549', 'Disease') :: ['incontinence'] @entity27081 :: ('MESH:C535672', 'Disease') :: ['anti-cholinergic refractory', 'AR'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['bladder fibrosis', 'bladder augmentation'] @entity4358 :: ('D014867', 'Chemical') :: ['H2O'] @entity1973 :: ('MESH:D001750', 'Disease') :: ['neuropathic bladder'] @entity46057 :: ('MESH:D064807', 'Disease') :: ['anticholinergic intolerance', 'AI']
@entity1973 :: (MESH:D001750,Disease) :: ['neuropathic bladder']
