• The use of botulinum toxin a in the treatment of neuromuscular dysfunction of the bladder in children with spinal dyzrafia
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The use of botulinum toxin a in the treatment of neuromuscular dysfunction of the bladder in children with spinal dyzrafia

SOVREMENNAYA PEDIATRIYA. 2014.8(64):50–54; doi 10.15574/SP.2014.64.5

The use of botulinum toxin a in the treatment of neuromuscular dysfunction of the bladder in children with spinal dyzrafia

Shevchuk D. V.

Zhytomyr Regional Child's Clinical Hospital

Zhytomyr State University named after Ivan Franko

National Medical Academy of Postgraduate Education named after PL Shupyka

 

Summary. In patients with miyelodysplazia urination disorders are 95–98%. Found that 62% of patients with miyelodysplazia discoordination detrusor contraction and sphincter (sphincter-detruzo dyssynerhia) and are likely to use adequate permanent catheterization and anticholinergic drugs. In addition, 45% of patients observed a violation of the locking properties sphincter. Botulinum toxin A-neurotoxic protein produced by the bacterium Clostridium botulinum with the presynaptic blocking effect, which provides the selective blockade of the detrusor during its intramuscular injection. It is proved that the BTA blocks muscle M2, M3, and R2H2 R2H3 receptors, which makes it possible to increase the volume of the bladder in children. Also, there is evidence that botulinum toxin A reduces the level of nerve growth factor (nerve growth factor (NGF)). In general, the positive effect of the use of botulinum toxin A is observed in 75% of children with miyelodysplazia. In this paper the clinical example of effective use of botulinum toxin A in a child with neuromuscular dysfunction of the bladder as a result of spinal dyzrafia. Thus, it was found that injection of botulinum toxin A intradetruzor is sufficiently effective and safe alternative in the surgical treatment of resistant forms of neuromuscular bladder dysfunction in children operated on dyzrafia spinal cord. The technique is simple in execution, is well tolerated by patients, the effect occurs in a relatively short time, has a prolonged effect. Intradetruzor injection of botulinum toxin A may be offered to all patients with sphincter-detruzor dyssynerhia and/or cistalgia anywhere in life.

Key words: neuromuscular dysfunction of bladder botulinum toxin A, surgical treatment, miyelodysplazia, children.

 

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