Study design, materials and methods
In our clinic , pediatric patients who had pure diagnosis of overactive bladder , failed to respond to anticholinergic therapy and had injection botulinum toxin type A intravesically were analyzed retrospectively . Patients with dysfunctional voiding neurogenic lower urinary tract dysfunction, patients with bladder stone were excluded from study. Patients’ ages, voiding dysfunction symptom scores, capacity, residual volume, urodynamic data were recorded . Technically, under general anesthesia and lithotomy position, pediatric cystoscope (storz 9,5 Fr, 6 degree ) inserted to bladder and 4 mm adjustable needle (Laborie, InjeTak cystoscope adjustable needle 2 - 5 mm ) was used in order to exact deep injection. 100 units ona - botulinumtoxin diluted with 20 cc saline . Diluted ona - botulinumtoxin injected randomly into the bladder wall. Each injection volume was 1 ml . Totally 20 different point 20 cc 100 units botulinumtoxin were injected without trigon. after injection bladder was emptied with temporary foley catheter.
Interpretation of results
Mean follow‐up of the patients was 10.2 ± 6 months . Duration of preoperative anticholinergic drug using was calculated as 10.2 ± 4 months . Postoperative symptom score and daily incontinence episodes were seen to decrease to 8.2 ± 8.5 (p = 0.042 ) and 0.2 ± 0.4 ( p = 0.046 ) . Bladder capacity increased from 140 ± 45 mL to 206 ± 109 mL (p = 0.043 ) . Residual urine volume decreased from 31 ± 31 mL to 25 ± 25 mL (p = 0.7) . Peak flow rate increased from 16.8 ± 7.9 mL / sec to 18.4 ± 8.7mL / sec (p = 0.1) . The average flow rate increased from 8.6 ± 4.3 mL/sec to 7.2 ± 2.7 mL / sec (p = 0.1) . There was no postoperative complication according to Clavien classification. None of the patients had vesicoureteral reflux .