Pd04-07 Long Term Outcomes of Intradetrusor Onabotulinumtoxina Use in Pediatric Patients With Spina Bifida

You have accessJournal of UrologyPediatrics I (PD04)1 May 2024PD04-07 LONG TERM OUTCOMES OF INTRADETRUSOR ONABOTULINUMTOXINA USE IN PEDIATRIC PATIENTS WITH SPINA BIFIDA Brendan T. Frainey, Leslie M. Peard, Belinda T. Li, Shilin Zhao, Cyrus Adams, Abby Taylor, John Thomas, John Pope, Mark Adams, John Brock, and Douglass Clayton Brendan T. FraineyBrendan T. Frainey , Leslie M. PeardLeslie M. Peard , Belinda T. LiBelinda T. Li , Shilin ZhaoShilin Zhao , Cyrus AdamsCyrus Adams , Abby TaylorAbby Taylor , John ThomasJohn Thomas , John PopeJohn Pope , Mark AdamsMark Adams , John BrockJohn Brock , and Douglass ClaytonDouglass Clayton View All Author Informationhttps://doi.org/10.1097/01.JU.0001008812.05762.7f.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The long-term efficacy and role of repeated onobotulinumtoxin A (BTX) injections for the management of pediatric neurogenic bladder remains undefined. The aims of this study were to characterize the use of BTX in patients with spina bifida (SB) and compare long-term management outcomes for this cohort. METHODS: We conducted a retrospective single-institution review of all pediatric SB patients undergoing BTX injections between 06/2013 and 08/2022. Demographic, clinical, radiographic and videourodynamic (VUD) variables were analyzed. Key variables were compared between 3 pre-defined long-term management outcomes in subjects with>5 years follow-up (FU): (1) patients receiving regular BTX, (2) requiring bladder reconstruction, or (3) using only clean intermittent catheterization (CIC) +/- anticholinergics (AC). RESULTS: Eighty-seven subjects met inclusion criteria. Median number of BTX procedures per patient was 2 IQR 1-5 and age at first BTX was 8.8 5.9-12.4 years. Additional demographic and clinical characteristics can be found in Table 1. 41/87 (47%) subjects had>5 years FU. At last FU bladder management consisted of regular BTX injections in 15/41 (37%), bladder reconstruction in 12/41 (29%), and CIC +/- AC in 14/41 (34%). Patients undergoing regular BTX injections had a median of 6 IQR 5-8 procedures as compared to 2 procedures for those who underwent reconstruction or were on CIC+/-AC (p<0.001). Neither age at first BTX, pre-BTX VUD parameters, nor radiographic findings differed between groups (Table 2). Patients getting routine BTX had significantly higher median bladder capacity on initial post-BTX VUDS (300cc) than those who progressed to reconstruction (180cc) or were on CIC +/- AC (206cc) (p=0.04). CONCLUSIONS: Thirty-seven percent of SB patients with long-term FU have been successfully managed with regular BTX injections. Repeat VUD after initial BTX injection may help identify patients who may benefit from repeat injections, but identifying objective criteria to predict long-term success remains challenging. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e85 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Brendan T. Frainey More articles by this author Leslie M. Peard More articles by this author Belinda T. Li More articles by this author Shilin Zhao More articles by this author Cyrus Adams More articles by this author Abby Taylor More articles by this author John Thomas More articles by this author John Pope More articles by this author Mark Adams More articles by this author John Brock More articles by this author Douglass Clayton More articles by this author Expand All Advertisement PDF downloadLoading ...