PDF(Pubmed)
Abstract：
The objective of this study was to assess the clinical effectiveness and safety of type A botulinum toxin in the treatment of refractory overactive bladder in adolescents. We conducted a retrospective analysis of 37 adolescent patients with refractory overactive bladder who were treated at the Urology Department of Hangzhou Third People\'s Hospital between January 2018 and August 2023. These patients received intravesical injections of type A botulinum toxin at a concentration of 10 U/mL, with an average of 20 injection points. We recorded changes in urination diaries and urodynamic parameters both before and 1 month after treatment. After 1 month of treatment, significant improvements were observed in several parameters, when compared to the pretreatment values. These included daytime frequency of urination (11.13 ± 6.45), average single void volume (173.24 ± 36.48) mL, nighttime frequency of urination (2.43 ± 0.31), urgency episodes (3.12 ± 0.27), initial bladder capacity (149.82 ± 41.34) mL, and maximum bladder capacity (340.25 ± 57.12) mL (all P < .001). After the first treatment, 5 patients had mild hematuria, 4 patients had urinary tract infection, and 1 patient had urinary retention, which was relieved after catheterization. No serious complications or adverse reactions were observed in other patients. The follow-up period ranged from 6 to 18 months, and the duration of efficacy varied from 2 to 8 months. Eight patients who initially had treatment failure achieved symptom relief after reinjection. In adolescents with refractory overactive bladder who do not respond well to conventional drug therapy, type A botulinum toxin can be administered safely and effectively. It significantly improves lower urinary tract symptoms and enhances the quality of life for these patients.
摘要：
这项研究的目的是评估A型肉毒杆菌毒素治疗青少年难治性膀胱过度活动症的临床有效性和安全性。回顾性分析2018年1月至2023年8月杭州市第三人民医院泌尿外科收治的37例青少年难治性膀胱过度活动症患者。这些患者接受10U/mL浓度的A型肉毒毒素膀胱内注射，平均有20个注射点。我们记录了治疗前和治疗后1个月的排尿日记和尿动力学参数的变化。治疗1个月后，在几个参数中观察到了显著的改善，当与预处理值比较时。这些包括白天排尿频率（11.13±6.45），平均单个空隙体积（173.24±36.48）mL，夜间排尿频率(2.43±0.31),紧急发作（3.12±0.27），初始膀胱容量（149.82±41.34）mL，最大膀胱容量（340.25±57.12）mL（均P<.001）。第一次治疗后,5例患者有轻度血尿，4例患者有尿路感染，1例患者有尿潴留,插管后缓解了。其他患者均未出现严重并发症或不良反应。随访时间6~18个月,疗效持续时间从2到8个月不等。最初治疗失败的八名患者在重新注射后症状缓解。在对常规药物治疗反应不佳的难治性膀胱过度活动症青少年中，A型肉毒毒素可以安全有效地给药。它显着改善了下尿路症状，并提高了这些患者的生活质量。
