An evaluation of onobotulinumtoxinA as a therapeutic option for pediatric neurogenic detrusor overactivity.
Expert Rev Neurother
; 23(9): 763-774, 2023.
Article
en En
| MEDLINE
| ID: mdl-37556757
ABSTRACT
INTRODUCTION:
Neurogenic detrusor overactivity (NDO) results in involuntary detrusor contractions during bladder filling or storage risking transmission of pressure to the upper urinary tracts and/or significant incontinence. The goals of bladder management in children with NDO prioritize the preservation of renal function, prevention of UTIs, and optimizing quality of life. First-line measures include intermittent catheterization and anticholinergic medication. However, when conservative measures fail, surgical intervention may be indicated. Historically, the next step was major reconstructive surgery to create a low-pressure urinary reservoir. The introduction of intravesical botulinum neurotoxin A (BoNT/A) for use in children in 2002 offered a less invasive option for management. However, its exact role is still evolving. AREAS COVERED This article summarizes the mechanism of action of BoNT/A for management of NDO and evaluates the current literature defining common practice and clinical efficacy in children with NDO. The findings of the recently completed phase III trial for intravesical onabotulinumtoxinA in children are discussed in detail. EXPERT OPINION As the first BoNT/A approved for use in children with NDO, onabotulinumtoxinA appears to be a safe and less invasive alternative to major reconstructive surgery. However, data defining appropriate patient selection and its role as a long-term treatment option continue to develop.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Vejiga Urinaria Neurogénica
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Toxinas Botulínicas Tipo A
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Vejiga Urinaria Hiperactiva
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Fármacos Neuromusculares
Idioma:
En
Revista:
Expert Rev Neurother
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos