{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:45:21Z","timestamp":1791229521173,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Evaluating the effectiveness and safety of repeated high\u2010dose intradetrusor abobotulinumtoxin A (Dysport\u00ae) injections for the treatment of pediatric neurogenic bladders refractory to medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective interventional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>The cohort included 37 children (22 boys and 15 girls) of median age 9.2 years. Inclusion criteria were diagnosis of neurogenic bladder and failure to respond to medical treatment. Exclusion criteria were augmented bladder, insufficient data, and interval of &gt;\u200911 months between video\u2010urodynamic study and Dysport injection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>All participants were treated with an intra\u2010detrusor injection of Dysport 30\u2009IU\/kg (up to 1000\u2009IU) under general anesthesia. Repeated (second and third) injections were scheduled (6\u201312 months) in patients who demonstrated an improvement in cystometric parameters. All participants underwent video urodynamic testing before onset of treatment and 4\u20135 months after subsequent injection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Success of treatment was defined as a decrease in end filling pressure (EFP) to &lt;\u200940\u2009cm H<jats:sub>2<\/jats:sub>O and\/or a 20% increase in maximal cystometric capacity (MCC). These parameters along with initial bladder features were evaluated for ability to predict treatment success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No side effects of Dysport were observed or reported. The overall success rate was 62%. MCC increased by a median of 30% (IQR 200\u2013300, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), 37% (IQR 197\u2013310, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and 45% (IQR 245\u2013300, <jats:italic>p<\/jats:italic>\u2009=\u20090.025) after the first, second and third injections, respectively. Median EFP decreased from 45\u2009cm H<jats:sub>2<\/jats:sub>O to 34\u2009cm H<jats:sub>2<\/jats:sub>O (IQR 20\u201345, <jats:italic>p<\/jats:italic>\u2009=\u20090.029), 23\u2009cm H<jats:sub>2<\/jats:sub>O (IQR 20\u201337, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), and 20\u2009cm H<jats:sub>2<\/jats:sub>O (IQR 12\u201332, <jats:italic>p<\/jats:italic>\u2009=\u20090.049) after the first, second, and third injections, respectively. No predicting factor of success of treatment were found; However, three of five cases of \u201cend stage\u201d bladder showed improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010dose Dysport injection is safe and effective for the treatment of neurogenic bladder. Studies with larger cohort and a control group would further elucidate which bladders would benefit most. At present, we recommend treating also bladders with \u201cend stage\u201d features with botulinum toxin before considering augmentation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25580","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T23:44:01Z","timestamp":1726011841000},"page":"2140-2146","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Success Rate and Predicting Factors for Repeated High\u2010Dose Intradetrusor Dysport Injections in Children With Neurogenic Bladder: A Retrospective Study"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4768-1160","authenticated-orcid":false,"given":"Yossi","family":"Ventura","sequence":"first","affiliation":[{"name":"Urologic Unit Schneider Children's Medical Center of Israel Petach Tikva Israel"},{"name":"Department of Urology Rabin Medical Center\u2010Beilinson Hospital Petach Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0073-1183","authenticated-orcid":false,"given":"Roy","family":"Morag","sequence":"additional","affiliation":[{"name":"Urologic Unit Schneider Children's Medical Center of Israel Petach Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"May","sequence":"additional","affiliation":[{"name":"Urologic Unit Schneider Children's Medical Center of Israel Petach Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Khunovitz","sequence":"additional","affiliation":[{"name":"Urologic Unit Schneider Children's Medical Center of Israel Petach Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-3581","authenticated-orcid":false,"given":"David","family":"Ben Meir","sequence":"additional","affiliation":[{"name":"Urologic Unit Schneider Children's Medical Center of Israel Petach Tikva Israel"},{"name":"School of Medicine, Faculty of Medical and Health Science Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/145749691110000405"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/763159"},{"issue":"7","key":"e_1_2_12_4_1","first-page":"693","article-title":"[Intravesical Oxybutynin Treatment for Neurogenic Detrusor Overactivity: Efficacy and Safety Data From Clinical Practice With the First Intravesical Oxybutynin Treatment Authorized in Germany]","volume":"63","author":"Schindler O.","year":"2024","journal-title":"Urologie (Heidelberg, 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