Abstract

Objective:
Pediatric neurogenic bladder (NB) represents a challenging condition that jeopardizes both lower and upper urinary tract integrity. This study aimed to evaluate the pressure-lowering efficacy of intradetrusor botulinum toxin A (BTX-A) in children with spinal-origin NB and to identify clinical and urodynamic factors predicting treatment response.
Materials and Methods:
In this retrospective cohort study, 38 pediatric patients with spinal-origin NB who received 100 IU of BTX-A between October 2023 and December 2024 were analyzed. BTX-A was injected cystoscopically at 20 detrusor sites, sparing the trigone. The primary outcome was the 6-month change in storage-phase detrusor pressure (Δp_det), calculated as p_det = p_ves − p_abd in accordance with ICCS standards. Secondary outcomes included an exploratory categorical responder endpoint (≥10 cmH₂O reduction in storage pressure) and attainment of guideline-based safe storage thresholds (

Key words: Pediatric neurogenic bladder, Botulinum toxin A, Detrusor pressure, Renal function, Spinal dysraphism