ESPU Congress 2018 - Abstract Book

192 29 th CONGRESS OF THE ESPU 13:14–13:19 S26-6 (LO) ★ BOTULINUM TOXIN TYPE-A INJECTIONS FOR THE TREATMENT OF CONTINENT CATHETERIZABLE RESERVOIR MUSCULARIS OVERACTIVITY IN PEDIATRIC PATIENTS Luis SIERRA, Laia SABIOTTE, Erika LLORENS and Anna BUJONS Fundació Puigvert, Pediatric urology Unit, Barcelona, SPAIN PURPOSE Continent catheterizable reservoirs can exhibit complications such as high pressures and involun- tary unit contractions. The use of onabotulinum toxin-A injections could be a treatment to explore. The purpose is to evaluate the efficacy and safety of intravesical injection of onabotulinumtoxinA (BOTOX) as a treatment in the management of overactive bladder in patients with continent cath- eterizable reservoirs. MATERIAL AND METHODS A prospective study was carried between 2013–2016 to evaluate the efficacy of botulinum toxin treatment in pediatric patients with mean age of 14 years old (R 8–16) with muscularis overactivity in continent catheterizable reservoirs after failing maximal doses of oral anticholinergic medications. Urodynamic studies demonstrated phasic neobladder overactivity: 95 mL (up to 40 cm H2O) and 173 mL (up to 83 cm H2O with leakage). These patients underwent reservoir injections under general anesthesia via appendicovesicostomy. The initial dose used was 200 units and was increased to 300 units in 20 separate injection sites to improve results and durability. RESULTS 11 injections of BOTOX were performed in 6 patients. All patients improved their incontinence and urgence after BOTOX. Postinjection urodymamic studies showed normal filling with improvement of overactivity bladder. Mean time to relapse of symptoms after injection of BOTOX was 8 months (R6–12). There were no complications in any cases. Mean time to reinjection of botox was 14 months (R9–18). Average follow-up time 48 months (R 12–36). CONCLUSIONS Intravesical injection of BOTOX may be considered as a treatment option for overactive symptoms in patients with continent catheterizable reservoirs, although further studies are needed to verify the complications and long-term outcomes of this procedure.