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Journal articles
Intradetrusor Injections of Botulinum Toxin Type A in Children With Spina Bifida: A Multicenter Study
Juliette Hascoet
1
Benoit Peyronnet
2
Veronique Forin
3
Maximilien Baron
4
Grégoire Capon
5
Thomas Prudhomme
6
Clément Allenet
5
Simon Tournier
3
Charlotte Maurin
7
Jean-Nicolas Cornu
8, 9, 10, 11
Ourdia Bouali
12
Matthieu Peycelon
13
Alexis Arnaud
14
Mariette Renaux-Petel
15
Agnès Liard
15
Gilles Karsenty
16
Andrea Manunta
17
Xavier Gamé
6
15
CHU Rouen
Juliette Hascoet 1
Author
Benoit Peyronnet 2
Author
Veronique Forin 3
Author
Maximilien Baron 4
Author
Charlotte Maurin 7
Author
Jean-Nicolas Cornu 8, 9, 10, 11
Author
Ourdia Bouali 12
Author
Matthieu Peycelon 13
Author
Alexis Arnaud 14
Author
Mariette Renaux-Petel 15
Author
Agnès Liard 15
Author
Gilles Karsenty 16
Author
Andrea Manunta 17
Author
Xavier Gamé 6
Author
1
UNIV-RENNES - Université de Rennes (France)
2
Service d'urologie (2 rue Henri Le Guilloux 35033 Rennes cedex 9 - France)
- UR1 - Université de Rennes 1 (2 rue du Thabor - CS 46510 - 35065 Rennes cedex - France)
- UNIV-RENNES - Université de Rennes (France)
- Hôpital Pontchaillou (France)
- CHU Pontchaillou [Rennes] (2 Rue Henri le Guilloux, 35000 Rennes - France)
3
Service de réhabilitation pédiatrique [CHU Trousseau] (France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
- CHU Trousseau [APHP] (26 Avenue du Dr Arnold Netter, 75012 Paris - France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
- Sorbonne Université (France)
4
Service d'urologie [Rouen] (1, rue de Germont, 76038 Rouen cedex - France)
- CHU Rouen (1, rue de Germont 76031 Rouen cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- UNIROUEN - Université de Rouen Normandie (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
5
service d'urologie [CHU Bordeaux] (Bordeaux - France)
- CHU Bordeaux [Bordeaux] (place Amélie Raba Léon 33076 BORDEAUX CEDEX - France)
6
CHU Toulouse [Toulouse] (Hôtel-Dieu Saint Jacques
2, rue Viguerie
TSA 80035
31059 Toulouse cedex 9 - France)
7
CHU Marseille (France)
8
Service d'urologie [CHU Tenon] (Paris - France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
- CHU Tenon [APHP] (4 Rue de la Chine, 75020 Paris - France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
- Sorbonne Université (France)
9
ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (22 bd Gambetta
76183 Rouen Cedex - France)
- UNIROUEN - Université de Rouen Normandie : U1073 (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- INSERM - Institut National de la Santé et de la Recherche Médicale : U1073 (101, rue de Tolbiac, 75013 Paris - France)
10
IRIB - Institute for Research and Innovation in Biomedicine (22 Boulevard Gambetta
76183 Rouen Cedex - France)
- UNIROUEN - Université de Rouen Normandie : FED 4220 (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- INSERM - Institut National de la Santé et de la Recherche Médicale : FED 4220 (101, rue de Tolbiac, 75013 Paris - France)
- CNRS - Centre National de la Recherche Scientifique (France)
11
UNIROUEN UFR Santé - UNIROUEN - UFR Santé (22 boulevard Gambetta - CS 76183 - 76183 Rouen cedex 1 - France)
- UNIROUEN - Université de Rouen Normandie (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
12
Hôpital Purpan [Toulouse] (Place du Docteur Baylac
TSA 40031
31059 Toulouse cedex 9 - France)
- CHU Toulouse [Toulouse] (Hôtel-Dieu Saint Jacques 2, rue Viguerie TSA 80035 31059 Toulouse cedex 9 - France)
13
CHU Trousseau [APHP] (26 Avenue du Dr Arnold Netter, 75012 Paris - France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
- Sorbonne Université (France)
14
Service de chirurgie pédiatrique [Rennes] (Rennes - France)
- UR1 - Université de Rennes 1 (2 rue du Thabor - CS 46510 - 35065 Rennes cedex - France)
- UNIV-RENNES - Université de Rennes (France)
- CHU Pontchaillou [Rennes] (2 Rue Henri le Guilloux, 35000 Rennes - France)
15
CHU Rouen (1, rue de Germont 76031 Rouen cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
16
Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM] (Hôpital de la Conception
147, boulevard Baille
13005
Marseille
- France)
- AMU - Aix Marseille Université (Aix-Marseille Université Jardins du Pharo 58 Boulevard Charles Livon 13284 Marseille cedex 7 - France)
- APHM - Assistance Publique - Hôpitaux de Marseille (Direction générale AP-HM 80, rue Brochier 13 354 Marseille Cedex 5 - France)
- LA CONCEPTION - Hôpital de la Conception [CHU - APHM] (147 Boulevard Baille 13005 Marseille - France)
17
CHU Pontchaillou [Rennes] (2 Rue Henri le Guilloux, 35000 Rennes - France)
Abstract : OBJECTIVE:
To assess the effectiveness of intradetrusor injections of botulinum toxin type A (IDBTX-A) in children with spina bifida.
METHODS:
All patients aged less than 16 years old who underwent IDBTX-A between 2002 and 2016 at 6 institutions were included in a retrospective study. Our primary endpoint was the success rate of IDBTX-A defined as both clinical improvement (no incontinence episodes between clean intermittent catheterizations [CICs], absence of urgency, and less than 8 CICs per day) and urodynamic improvement (resolution of detrusor overactivity and normal bladder compliance for age) lasting ≥12 weeks. Predictive factors of success were assessed through univariate analysis.
RESULTS:
Fifty-three patients with a mean age of 8.5 years were included. All patients were under CIC and 88.7% had received anticholinergics with either poor efficacy or bothersome adverse events. The global success rate of the first injection (clinical and urodynamic) was 30%. Patients with closed spinal dysraphism had a significantly better success rate than patients with myelomeningocele (P = .002). The clinical success rate was 66% and was significantly associated with maximum urethral closure pressure (34 cm H2O vs 54.4 cm H2O, P = .02). The urodynamic success rate was 34%. Maximum cystometric capacity (P <.0001) and compliance (P = .01) significantly improved after the first IDBTX-A and maximum detrusor pressure tended to decrease (P = .09) except in the subgroup of patients with poor compliance. After a mean follow-up of 3.7 years, 23 patients (43.4%) required augmentation cystoplasty. Excluding 6 patients who were lost to follow-up, 38.3% of patients were still undergoing botulinum toxin injections at last follow-up.
CONCLUSION:
In this series, despite the fact that IDBTX-A enabled clinical improvement in 66% patients, urodynamic outcomes were poor resulting in a low global success rate (30%).
Document type :
Journal articles
Complete list of metadata
https://hal-normandie-univ.archives-ouvertes.fr/hal-02402881
Contributor : Sabine Douville <>
Submitted on : Tuesday, December 10, 2019 - 4:16:22 PM
Last modification on : Friday, December 11, 2020 - 3:20:43 AM
Contributor : Sabine Douville <>
Submitted on : Tuesday, December 10, 2019 - 4:16:22 PM
Last modification on : Friday, December 11, 2020 - 3:20:43 AM
Identifiers
- HAL Id : hal-02402881, version 1
- DOI : 10.1016/j.urology.2018.02.033
Collections
COMUE-NORMANDIE | ADEN | UNIROUEN | UNIV-RENNES1 | UNIV-RENNES | UNIV-AMU | CNRS | SORBONNE-UNIVERSITE
Citation
Juliette Hascoet, Benoit Peyronnet, Veronique Forin, Maximilien Baron, Grégoire Capon, et al.. Intradetrusor Injections of Botulinum Toxin Type A in Children With Spina Bifida: A Multicenter Study. Urology, Elsevier, 2018, 116, pp.161-167. ⟨10.1016/j.urology.2018.02.033⟩. ⟨hal-02402881⟩
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