Safety of 200iU of intravesical Botox in children of all ages with functional urinary incontinence.

[PURPOSE] Intravesical Botox injection can be effective in children with functional urinary incontinence refractory to conservative measures. A wide range of potential doses have been reported with concerns regarding the safety of higher doses. This study aims to determine the safety and side effect profile of 200iU of Botox in children of all ages with functional urinary incontinence.

[METHODS] A retrospective review of 143 children who received 200iU of botulinum toxin A utilising intradetrusor injections was performed. All children had urinary incontinence with no defined neurological abnormality. Post-operative complications were analysed, including UTI, adverse drug reactions, pain, haematuria, urinary retention, transitory increased incontinence and systemic adverse effects.

[RESULTS] A total of 228 injection procedures (range: 1-6 procedures) in 143 children (70 girls, 73 boys) were included. Median age at first treatment was 9 years (range: 4-17 years). The mean number of treatment cycles required per patient was 1.59 (range: 1-6). There were no intra-operative complications. Post-operative complications included UTI, post-operative pain and haematuria. No complication required re-admission and no cases of urinary retention requiring catheterisation occurred.

[CONCLUSION] This study represents the largest population to date of children with functional urinary incontinence treated with intravesical Botox, confirming this as a well-tolerated, safe intervention in all ages with complications as would be expected for cystoscopy alone.