Academic Journal
Preoperative urodynamic factors predicting outcome of botulinum toxin-A intradetrusor injection in children with neurogenic detrusor overactivity.
| العنوان: | Preoperative urodynamic factors predicting outcome of botulinum toxin-A intradetrusor injection in children with neurogenic detrusor overactivity. |
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| المساهمون: | Sang Woon Kim, Jae Hyeok Choi, Yong Seung Lee, Sang Won Han, Young Jae Im, Kim, Sang Woon, Lee, Yong Seung, Im, Young Jae, Han, Sang Won |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Botulinum Toxins, Type A/therapeutic use, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Humans, Injections, Intralesional, Male, Multivariate Analysis, Predictive Value of Tests, Preoperative Care/methods, Retrospective Studies, Risk Assessment, Treatment Outcome, Urinary Bladder, Neurogenic/diagnosis, Neurogenic/drug therapy, Neurogenic/surgery, Overactive/diagnosis, Overactive/drug therapy, Overactive/surgery, Urodynamics |
| الوصف: | OBJECTIVE: To investigate urodynamic (UD) parameters that predict outcome of intradetrusor botulinum toxin-A (BTX-A) injection in children with neurogenic detrusor overactivity (NDO), by reviewing clinical and UD data. METHODS: From January 2010 to March 2014, 56 cases of the first BTX-A intradetrusor injection were performed in pediatric patients with NDO. We excluded 19 cases based on these criteria: patient age <4 years, no preoperative UD study or postoperative outcome assessment, and simultaneous sphincter injection. Based on the Patient Global Impression of Improvement, patients were classified as responders or nonresponders. RESULTS: Thirty-seven cases were included finally. Mean number of pads used per day was significantly decreased after BTX-A injection (2.67 짹 1.46 vs 1.37 짹 1.15; P <.001). On postoperative UD study, maximum cystometric capacity and residual urine volume were significantly increased above baseline. Persistent NDO was only detected in 3 cases (8.1%). Regardless of UD improvements, 20 cases were responders, whereas 17 were nonresponders based on Patient Global Impression of Improvement. Preoperative bladder compliance was significantly lower in nonresponders (25.11 짹 32.59 vs 8.64 짹 6.52; P = .039). Open bladder neck (OBN) was seen in 9 cases and more likely occurred in nonresponders. Regression analysis revealed that poor bladder compliance (<10 mL/cm H2O; odds ratio, 6.041; 95% confidence interval, 1.189-30.677; P = .030) and presence of OBN (odds ratio, 16.889; 95% confidence interval, 1.825-156.282; P = .031) were independent predictors of poor response after BTX-A injection. CONCLUSION: Preoperative bladder compliance and OBN were important predictors of outcome after BTX-A intradetrusor injection. Thus, intradetrusor BTX-A injection should be considered in select patients to achieve optimal outcome. ; open |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | 1480~1484 |
| اللغة: | unknown |
| تدمد: | 0090-4295 1527-9995 25432842 |
| Relation: | UROLOGY; J02775; OAK-2014-03246; https://ir.ymlib.yonsei.ac.kr/handle/22282913/138979; http://www.sciencedirect.com/science/article/pii/S0090429514009765; T201405872; UROLOGY, Vol.84(6) : 1480-1484, 2014 |
| DOI: | 10.1016/j.urology.2014.09.001 |
| الاتاحة: | https://ir.ymlib.yonsei.ac.kr/handle/22282913/138979 https://doi.org/10.1016/j.urology.2014.09.001 http://www.sciencedirect.com/science/article/pii/S0090429514009765 |
| Rights: | CC BY-NC-ND 2.0 KR ; https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ ; free |
| رقم الانضمام: | edsbas.43CD6AFB |
| قاعدة البيانات: | BASE |
| تدمد: | 00904295 15279995 25432842 |
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| DOI: | 10.1016/j.urology.2014.09.001 |