Mp28-19 contemporary trend analysis of intra-detrusor botox injection and augment cystoplasty for spina bifida population in us free-standing childrens hospitals

You have accessJournal of UrologyCME1 May 2022MP28-19 CONTEMPORARY TREND ANALYSIS OF INTRA-DETRUSOR BOTOX INJECTION AND AUGMENT CYSTOPLASTY FOR SPINA BIFIDA POPULATION IN US FREE-STANDING CHILDRENS HOSPITALS Hsin-Hsiao Wang, Kenneth Softness, John Panagides, Dylan Cahill, Rachel Saunders, Ranveer Vasdev, Tanya Logvinenko, and Carlos Estrada Hsin-Hsiao WangHsin-Hsiao Wang More articles by this author , Kenneth SoftnessKenneth Softness More articles by this author , John PanagidesJohn Panagides More articles by this author , Dylan CahillDylan Cahill More articles by this author , Rachel SaundersRachel Saunders More articles by this author , Ranveer VasdevRanveer Vasdev More articles by this author , Tanya LogvinenkoTanya Logvinenko More articles by this author , and Carlos EstradaCarlos Estrada More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002571.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intra-detrusor botulinum toxin (botox) injection has been utilized as a minimally invasive alternative to augmentation cystoplasty in patients with refractory neurogenic bladder. However, little data are available regarding its use on a national level. We sought to investigate the contemporary trends of intra-detrusor botox injection and augment cystoplasty in free-standing children’s hospitals. METHODS: We queried the Pediatric Health Information System (PHIS) database to identify patients with spina bifida from 2013 to 2019 who underwent intra-detrusor botox injection and augment cystoplasty based on CPT and ICD9/10 codes. Total spina bifida population under care in the free-standing children’s hospitals was estimated by all inpatient and ambulatory surgery encounters as denominators to calculate frequency by time for both intra-detrusor botox injections and augmentation cystoplasty. RESULTS: In total, we included 3,153 intra-detrusor botox injections and 1,828 augment cystoplasties between 2013 to 2019. 46% of patients were male. Median age at surgery was 10.6 (IQR 7.1-15.0) years. The contemporary trend (in quarters) for botox injection and augment cystoplasty are shown in Figure 1. There was a significantly increasing trend for intra-detrusor botox injection in patients with spina bifida (from 2.0% in 2013q1 to 12.3% in 2019q4, p<0.001 for the trend). Conversely, there was a decreasing but not significant trend for augment cystoplasty (from 3.9% in 2013q1 to 3.3% in 2019q4, p=0.11 for the trend). Strong seasonality (higher in summer) was seen in augment cystoplasty but not intra-detrusor botox injection group. The sensitivity analysis using only first intra-detrusor botox injection per patient led to similarly significant increasing trend with time. CONCLUSIONS: There is a significantly increased use of intra-detrusor botox injection in the management of neurogenic bladder in patients with spina bifida. The use of augmentation cystoplasty has slightly decreased, but not significantly. These trends are likely reflective of changing practice patterns, but the role of botox in the management of pediatric neurogenic bladder remains incompletely defined. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e468 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hsin-Hsiao Wang More articles by this author Kenneth Softness More articles by this author John Panagides More articles by this author Dylan Cahill More articles by this author Rachel Saunders More articles by this author Ranveer Vasdev More articles by this author Tanya Logvinenko More articles by this author Carlos Estrada More articles by this author Expand All Advertisement PDF DownloadLoading ...