Extended experience with the use of botulinum toxin a in children with overactive bladder (OAB)
Purpose In a pilot study we showed promising results for injections with botulinum toxin A in children with a therapy resistant overactive bladder. After this retrospective study we decided to continue with a prospective uncontrolled evaluation in the pediatric age group. The results are given and discussed. Material and methods Children with a history of therapy resistant diurnal and/or nocturnal incontinence based on urodynamically proven detrusor overactivity with normal bladder emptying were included. Children were treated under general anesthesia. A dose of 100 IU botulinum toxin A (Botox®, Allergan) diluted in 20 ml normal saline was injected. Both becoming dry and changing from day and nighttime incontinence to monosymptomatic enuresis were considered successful treatment. Results Seventy five patients met the inclusion criteria of which were 48 males and 27 females. Mean age at start of therapy was 112 months (9.3 years). The average follow-up was 17,37 months. Fifty eight children suffered day and night time incontinence, 5 suffered diurnal incontinence, 10 suffered nocturnal enuresis and 2 had giggle-incontinence. For the whole study group the mean voided volume increased from 176 ml to 245 ml after the first injection (p  Conclusions Botulinum toxin A injection seems a safe and efficient treatment for children suffering OAB. Further studies are needed.