Masteronderzoek Urologie - Botox versus Bladder

Botox versus Bladder Augmentation: can Botox prevent or postpone a bladder augmentation?

Achtergrond
Bladder augmentation is a surgical procedure with a long history. It is the treatment of choice for neurogenic bladders after failure of more conservative treatment or in case of upper urinary tract deterioration. Since the introduction of Botuline-Toxine A (BTA, Botox) in the medical field in the 1980’s, the indications for use of BTA have increased. This is a more conservative treatment option than the bladder augmentation. Even though it still requires general anesthesia in the pediatric population. BTA has been shown to delay bladder augmentation and even prevent redo bladder augmentation.

Over the past 20 years how did the number of procedures and indications for both bladder augmentation and BTA change? We also want to investigate whether BTA in the native part of an augmented bladder can prevent the need for re-augmentation? With these questions we want to test our hypothesis that the number of bladder augmentations has decreased and the number of BTA treatments had increased.

For this retrospective study we will evaluate the medical records of children with voiding disorders who have received BTA injections in the bladder or bladder augmentation or both at the departments of Paediatric Urology, of all the participating hospitals including the Erasmus MC - Sophia Children’s Hospital. Eligible children are children that received BTA in the bladder or Bladder Augmentation aged between 0 and 18 years old. Independent of their underlying disease (e.g. spina bifida, spinal cord lesions, posterior urethral valves) 

The primary parameter is to evaluate the number of procedures over time of BTA and bladder augmentation or both. Secondary parameters will include the following parameters: need for starting CIC after BTA; Re-augmentation numbers; BTA after augmentation; complications e.g. Clavien Dindo; (V)UDS parameters.

Doel van het onderzoek

• We are interested in the influence of BTA in regard to bladder augmentation. Over the past 20 years how did the number of procedures and indications for both bladder augmentation and BTA change?
• We also want to investigate whether BTA in the native part of an augmented bladder can prevent the need for re-augmentation?

With these questions we want to test our hypothesis that the number of bladder augmentations has decreased and the number of BTA treatments had increased.

Soort onderzoek en werkzaamheden student
Retrospectief dossieronderzoek

• Data verzamelen
• Analyses
• Manuscript schrijven (en publiceren)
• Indien tijd over: meelopen met klinische werkzaamheden, zoals poli en OK

Startmoment
Zomer of najaar 2024

Interesse?
Neem snel contact op met de begeleider van dit masteronderzoek: dr. Lisette ’t Hoen, kinderuroloog l.thoen@erasmusmc.nl

Referenties

• Radmayr C BG, Burgu B, Dogan HS, Nijman JM, Quaedackers J, Rawashdeh YHF, Silay MS, Stein R, Tekgül S, . EAU Guidelines on Paediatric Urology 2022.
• Schulte-Baukloh H, Knispel HH, Stolze T, Weiss C, Michael T, Miller K. Repeated botulinum-A toxin injections in treatment of children with neurogenic detrusor overactivity. Urology. 2005;66(4):865-70; discussion 70.
• Kim SJ, Nang QG, RoyChoudhury A, Kern AJM, Sheth K, Jacobs M, et al. Cost comparison of intra-detrusor injection of botulinum toxin versus augmentation cystoplasty for refractory neurogenic detrusor overactivity in children. J Pediatr Urol. 2022;18(3):314-9.