[Botulinum toxin use in adults and children with urinary tract function disorders]

Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Lopez A, Rey-Ares L, Bardach A, Regueiro A, Alcaraz A, Valanzasca P, Elorriaga N, Romano M, Rojas J
Record ID 32011000963
Authors' objectives:

To assess the available evidence on the efficacy, safety and other issues related with coverage policies on the use of BT in children and adults suffering neurogenic or idiopathic OBS.

Authors' recomendations: In adults, the evidence found shows that patients with neurogenic OBS refractory to antimuscarinic drugs might benefit from this technology achieving a significant improvement shown in a decreased number of incontinence daily episodes in approximately 70% of patients. However, this evidence comes from studies which included clinically heterogeneous populations and different interventions and comparators. The systematic reviews report different degrees of effect and are probably biased due to non-reported adverse effects. Effectiveness might be lower in patients with non-neurogenic OBS. As adverse effect, acute urinary retention was observed in 26-43%, requiring IC in 25% of the cases. The effect period seems to be of at least 6 months. Regarding sphincter or detrusor dyssynergia associated to Multiple Sclerosis (MS), there is no evidence to recommend its use and it is considered experimental and for investigational indications.Detrussor BT injections in children would bring a clinically significant improvement and seem to be well tolerated in children with neurogenic OBS and incontinence and non-neurogenic OBS refractory to antimuscarinic drug therapy. Regarding coverage policies, the use of BT for lower urinary tract indications has not been approved by the FDA; therefore some U.S. agencies do not cover it. It is also recommended that those patients scheduled for BT receive IC training.
Project Status: Completed
Year Published: 2011
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Urethral Diseases
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.