Uçar, MuratAkgül, Ahsen KaragözlüYücel, Cem2023-09-292023-09-292018-06-28Uçar, M. vd. (2018). ''Non-invasive evaluation of botulinum-A toxin treatment efficacy in children with refractory overactive bladder''. International Urology and Nephrology, 50(8), 1367-1373.0301-16231573-2584https://doi.org/10.1007/s11255-018-1926-6https://link.springer.com/article/10.1007/s11255-018-1926-6http://hdl.handle.net/11452/34154We aimed to evaluate the efficacy and safety of intravesical onabotulinum toxin A (onaBoNTA) injections for the treatment of children diagnosed with refractory overactive bladder (OAB) by using non-invasive methods. A total of 31 pediatric patients with a mean age of 10.2 years received intravesical onaBoNTA injection at the dose of 10 U/kg (max: 200 U). Twenty-one patients who failed to respond to the first injection, received second injection 6 months after the first one. The patients were retrospectively evaluated after the 1st and the 2nd injections by means of standardized questionnaire forms and voiding diary records. In the 6-month follow-up, 10 patients (32.2%) were determined to have full response after the first injection. The number of patients with partial response and no response were found to be 15 (48.4%) and 6 (19.4%), respectively. The mean value of Dysfunctional Voiding and Incontinence Symptom Score (DVISS) of the patients with full response was 8.5 before the injection, which decreased to 1 at 6-month follow-up and to 0.5 at 12-month follow-up (p < 0.001). Twenty-one patients without full response after the first injection received a second injection 6 months after the first one. Full response was achieved in 9 (42.9%) of the 21 patients who had a second injection, but only partial response was achieved in 9 (42.9%). Three (14.3%) of the remaining patients did not respond to the second injection either. 1-year follow-up evaluations revealed that the rates of the full response, partial response, and no response were 61.3, 29, and 9.7%, respectively. Based on our results, onaBoNTA therapy is an effective and reliable second-line off-label therapy in the management of patients with non-neurogenic OAB that is refractory to medical therapy. Asking the patients/guardians to fill out a standardized questionnaire form before and after the therapy enables easy and non-invasive assessment of the response to the therapy.eninfo:eu-repo/semantics/closedAccessUrology & nephrologyBotulinum toxin A.ChildrenOveractive bladderUrgencyUrinary incontinenceIdiopathic detrusor overactivityUrinary-incontinenceIntravesical oxybutyninTherapyAdministration, intravesicalAdolescentBotulinum toxins, type A.ChildDose-response relationship, drugFemaleFollow-up studiesHumansMaleNeuromuscular agentsRetrospective studiesTime factorsTreatment outcomeUrinary bladder, overactiveUrinationArticle0004406071000012-s2.0-850496001251367137350829968144Urology & nephrologyType A Botulinum Toxins; Incobotulinumtoxina; Intravesical Drug AdministrationBotulinum toxin A.CephalosporinOxybutyninTolterodineBotulinum toxin AMuscle relaxant agentAdolescentArticleChildClinical articleControlled studyDrug efficacyDrug safetyDrug treatment failureDysfunctional voiding and incontinence symptom scoreFemaleFollow upHumanMaleNon invasive procedureOff label drug useOveractive bladderQuestionnaireRetrospective studySchool childScoring systemTreatment responseDose responseIntravesical drug administrationMicturitionOveractive bladderPathophysiologyPhysiologyTime factorTreatment outcome