PDF(Pubmed)
Abstract：
Initial urologic management of pediatric neurogenic lower urinary tract dysfunction (NLUTD) includes clean intermittent catheterization (CIC) regimen and use of anticholinergic or beta3 agonist medications. Historically, NLUTD that did not respond to these initial management strategies received open surgical procedures such as augmentation cystoplasty (AC) to increase bladder capacity and create a lower-pressure reservoir. Since its first reported use in 2002, intradetrusor onabotulinumtoxinA (BTX-A) injections has developed an emerging role in management of pediatric NLUTD, culminating in its recent FDA-approval in 2021. In this review, the current evidence regarding the safety, tolerability, and efficacy of BTX-A use in pediatric NLUTD will be summarized. Additionally, we will attempt to define the current role of BTX-A in the management of patients with NLUTD, discuss limitations to the current body of literature, and suggest future avenues of study.
摘要：
小儿神经源性下尿路功能障碍（NTUTD）的初始泌尿外科治疗包括清洁间歇性导尿（CIC）方案和使用抗胆碱能或β3激动剂药物。历史上,对这些初始管理策略没有反应的NULTD接受了开放式外科手术，例如增强膀胱成形术（AC），以增加膀胱容量并创建较低压力的储液器。自从2002年首次报告使用以来，逼尿肌内注射鼻烟毒素A（BTX-A）已在儿科NNUTD的管理中发挥了重要作用。最终在2021年获得FDA批准。在这次审查中,目前关于安全性的证据,耐受性,将总结BTX-A在小儿NNUTD中的使用效果。此外,我们将尝试定义BTX-A在NTUTD患者管理中的当前作用，讨论对当前文学主体的限制，并建议未来的研究途径。
