Evidence map›Paper›PMID 34486166›Full record

ArticleNeurourology and urodynamics2021

Onabotulinumtoxin A (Botox): A reasonable alternative for refractory neurogenic bladder dysfunction in children and young adults.

Kenneth A Softness, Hatim Thaker, Didi Theva, Archana Rajender, Bartley G Cilento, Stuart B Bauer

Open access · greenAbstract read
In one paragraph

Article in Neurourology and urodynamics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  3. Review
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  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Kenneth A SoftnessDepartment of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-4592-8406
Hatim ThakerDepartment of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Didi ThevaDepartment of Urology, Boston Medical Center, Boston, Massachusetts, USA.
Archana RajenderDepartment of Urology, Boston Medical Center, Boston, Massachusetts, USA.
Bartley G CilentoDepartment of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Stuart B BauerDepartment of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Boston Children's Hospital · USBoston Medical Center · US

Funding

Research Training in Pediatric Urology/CHB T32T32DK060442 · NIDDK · CHILDREN'S HOSPITAL BOSTON · PI ADAM, ROSALYN M · 2002 to 2023
$2.5M
NIDDK NIH HHS T32 DK060442
6 · The paper itself

Abstract

aimsWe aimed to describe the effectiveness of Onabotulinumtoxin A (Botox) in children with neurogenic bladder (NGB) unresponsive to medical therapy to determine urodynamic parameters predictive of success.

methodsChildren receiving Botox for refractory NGB, between 2008 and 2019, from a single academic center, were included in this study. Botox success was defined as improvement of incontinence and/or urodynamic parameters.

resultsOf 34 patients who received Botox, 13 (38.2%) had a positive response from their first injection, with improvement in capacity by a median of 35% of expected capacity for age compared to only a 9% increase in those who did not respond clinically. When patients were divided into groups by baseline urodynamic parameters, high-pressure (Pdetmax > 20 cm H

conclusionIn our series, 38% had clinical success with intradetrusor Botox injections for refractory neurogenic bladder. When successful, improvement in capacity and compliance, DO, and/or incontinence was consistent with prior literature. While we could not determine which parameters predicted success, subdividing patients into categories based on baseline urodynamic parameters identified who would benefit from Botox treatment based on differential improvements in capacity and compliance. At least 1 injection of Botox should be considered for a subset of children with refractory NGB, before undertaking more invasive treatments.

Indexed as

Botulinum Toxins, Type ANeuromuscular AgentsUrinary Bladder, NeurogenicUrinary Bladder, OveractiveChildHumansUrodynamicsBotulinum Toxins, Type ANeuromuscular Agentsdetrusor overactivityneurogenic bladderOnabotulinumtoxin A

Identifiers

PMID34486166
PMCPMC8556295
OpenAlexW3198771594

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.