Résumé
L’hyperactivité du détrusor est une cause majeure de dégradation de l’appareil urinaire dans les vessies neurogènes de l’enfant. Les anticholinergiques et les agrandissements chirurgicaux de la vessie sont les traitements traditionnels. La neuromodulation des racines S3 (Interstim®) et la toxine botulique intravésicale (Botox® 12 mg/kg ou Dysport®) sont des techniques récentes validées chez l’adulte. Leur utilisation chez l’enfant est encore peu répandue. Cependant, les premiers résultats semblent équivalents à ceux obtenus chez l’adulte et sans effets indésirables spécifiques à l’enfant. N’ayant pas encore d’Autorisation de mise sur le marché (AMM), leur intérêt doit être validé par des séries multicentriques randomisées.
Abstract
Overactive bladder is a major cause of urinary tract damage in children with congenital neurogenic bladder. Anticholinergics and bladder augmentation are the standard treatments. S3 sacral neuromodulation (InterStim®) and botulinum toxin injection (Botox® 12 mg/kg or Dysport®) into the detrusor muscle have recently been shown to be effective in adults. In children, the use of these treatments is still uncommon but the first results are as promising as those in adults and no adverse effects have been reported. In France, there is a need for additionnal randomized, multicenter trials to confirm the benefits of these two procedures in paediatric urology.
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Aubert, D., Galli, G., Ramella, B. et al. Neuromodulation et toxine botulique dans les hyperactivités vésicales neurogènes de l’enfant. Pelv Perineol 2, 244–248 (2007). https://doi.org/10.1007/s11608-007-0137-x
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DOI: https://doi.org/10.1007/s11608-007-0137-x