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| |  AAP: Botox Injections Effective for Lazy Bladder Syndrome By Alison Palkhivala Special to DG News SAN FRANCISCO, CA -- October 23, 2001 -- Paralyzing the urethral sphincter with botulinum toxin A injections dramatically reduces the incidence of urinary tract infections in girls with lazy bladder syndrome, according to new research. Lazy bladder syndrome is a voiding dysfunction condition related to a spastic urethral sphincter resulting in recurring urinary tract infections (UTIs). While treatments are available, they are not effective in all sufferers. Dawn Diaz-Saldano, RN, CPNP, a urology clinical specialist in the division of pediatric urology at Children's Memorial Hospital in, Chicago, Illinois, United States, and colleagues investigated whether injections of the botulinum toxin type A (Botox), which causes muscle paralysis and is effective for adult neurogenic bladder problems, could reduce the number of UTIs experienced by children with lazy bladder syndrome. She presented their latest findings here this week at the National Conference and Exhibition of the American Academy of Pediatrics (AAP). For their study, Ms. Diaz-Saldano and colleagues treated 20 girls (mean age seven years) with lazy bladder syndrome first with injections of Botox (50 IU total) by quadrants into the external urethral center and then with physical disruption of the urethral sphincter muscle. The children were included prospectively and consecutively in this pilot study if they had had more than one UTI per year that was not responsive to conventional therapy and an enlarged bladder capacity (based on cystoscopy examination). After two years of follow-up, the incidence of UTIs decreased significantly and dramatically. Six girls who had wetting accidents ceased to have these accidents, and the parents reported that the children voided better. Voiding diaries revealed no statistical differences in voided volumes or interval of voiding after Botox injection. There were no complications associated with the procedure. "We found that in this select group of girls with UTIs who had failed conventional treatment Botox injection into the external urethral center coupled with sphincter muscle disruption significantly reduced the incidence of UTIs," said Ms. Diaz-Saldano. "Future controlled trials are needed to follow-up this pilot study."
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