Botulinum toxin-A beneficial to children with treatment-resistant dysfunctional voiding

In children with treatment-resistant dysfunctional voiding, the use of botulinum toxin-A (BTX-A) helps with postvoid residuals (PVR), urinary tract infections (UTIs), and incontinence, according to a study.

Researchers conducted a systematic review to summarize the effects and safety of intersphincteric BTX-A as a treatment for therapy-refractory dysfunctional voiding in children. Several online databases were searched for relevant studies. Data on PVR, maximum flow rate (Qmax), repeat injections, and complications were collected.

The search yielded 277 articles, of which five cohort studies were included in the review. The pooled population included 78 children (68 percent girls). Sample sizes varied between 10 and 20 children, with the mean or median age at the time of intervention ranging from 8 to 10.5 years.

Meta-analysis was not able to be performed due to lack of data. As such, the narrative synthesis approach was used to summarize the results.

In all studies, BTX-A injection led to a significant decrease in PVR and a lower incidence of UTIs. A 33-percent to 69-percent improvement in incontinence was reported in three studies.

Side effects of treatment included a transient increase in incontinence, UTIs, and transitory numbness to the gluteus muscle.

The findings suggest that BTX-A could be a safe and effective treatment option for therapy-resistant dysfunctional voiding in children.