ESPU Programme 2010 S75

and 22 male patients ,mean age was 8.4years +/� 2.4 SD (4-13 years).Average followup period 14 months (5-20). The averagefrequency of usage Peristeen� system wasevery 3 days.40 patients (88.8%) showed completedryness stool wise, with no soiling, 5 patientsshowed partial improvement with varyingdegree of faecal soiling. Out of the 45patients, 30 (68.8%) were able to switch

from diapers to underwear completely and 9(20 %) limited their use of diapers only atschool or long trips.The observed adverse events wereabdominal pain at the start of treatmentwhich disappears after a short time,catheter malfunction and leakage ofirrigation fluid were recorded in 4, 7 and 6patients respectively.

CONCLUSIONS

In our initial experience using the Peristeen�

system we found it an effective, safe, andeasy applicable conservative method ofbowel management in patients with NBD.

# S15-2 (PP)

THE EFFECTS AND SIDE-EFFECTS OF ENDOSCOPIC APPLICATION OF BOTULINUM TOXIN-A IN CHILDREN WITHNEUROGENIC BLADDER

Andrzej JANKOWSKI1, Pawel KROLL1, Jacek ZACHWIEJA2, Marek MURIAS3, Magdalena SKRZYPCZAK4 andAndrzej BLUMCZYNSKI21Poznan University of Medical Sciences, Pediatric Surgery, Traumatology and Urology, Poznan, POLAND, 2Poznan University of MedicalSciences, Pediatric Nephrology and Cardiology, Poznan, POLAND, 3Poznan University of Medical Sciences, Department of Toxycology,Poznan, POLAND, 4Adam Mickiewicz University in Poznan, Human Biological Development, Institute of Anthropology, Faculty of Biology,Poznan, POLAND

PURPOSE

To evaluate the effects and side-effects ofendoscopic application of Botulinum-A toxinin the treatment of overactive neurogenicbladder in children.

MATERIAL AND METHODS

A prospective, non placebo controlled study,conducted with the approval of a LocalEthics Committee. 142 procedures ofendoscopic, intradetrusor injections of BTXwere performed on 49 girls, and 37 boys,with neurogenic bladder overactivity, aged1-14 years (mean age 6,4 years). In all ofchildren decreased bladder capacity anddetrusor overactivity with urineincontinence were estimated incystometries despite of oral oxybutynintreatment. In 29 children one injection was

performed, in the rest one or more re-injections were performed. Two productswere used in weight dependent dosage:Dysport, Ipsen up to 50 U/ kg, Botox,Allergan up to 10 U/ kg body weight. Thedose was diluted in 10 ml 0.9% NaCl andinjected in 20 sites of bladder dome. Wecompared pre and post-procedure: volumesof catheterized urine, volumes, pressuresfrom cystometries. Statistical analyses wereperformed using nonparametric tests: theWilcoxon signed rank sum test and the UMann-Whitney test. A p-value of less than0.05 was considered statistically significant.

RESULTS

Values of neuro-urologic parameters(catheterized bladder volumes, cystometricbladder capacity, detrusor pressure)improved significantly in 76 to 81% of

patients after therapy (p<0.05). There wasfind such correlation as the younger patientthe more effective the percentage ofvolumes growth (p<0.05). The longest timeof effect after BTX injection lasted for 14months with the mean time of improvement8,3months. In 19 children elevated bodytemperature, in first days, in two otherpatients blurred vision and weakness ofupper extremities were observed in thepostoperative course.

CONCLUSIONS

Endoscopic administration of Botulinum-Atoxin improves functional parameters ofneurogenic bladder in children. It representsan alternative to surgical augmentation ofbladder and reduction of intravesicalpressures.

# S15-3 (PP)

RENIN-ALDOSTERONE AND VASOPRESSIN LEVELS IN PATIENTS WITH NEUROPHATIC BLADDER

Fabian SANCHEZ1, Laura ESPINOSA2, Pedro LOPEZ PEREIRA1, Laura BURGOS1, Roberto LOBATO1, Maria Jose MARTINEZURRUTIA1, Carlos DE LA TORRE1 and Enrique JAUREGUIZAR1

1Hospital La Paz, Pediatric Urology, Madrid, SPAIN, 2Hospital La Paz, Pediaric Nephrology, Madrid, SPAIN

PURPOSE

In a previous study in neuropathic patientswith an augmented bladder we detectedthat 82% of them had low renin andaldosterone levels. The aim of this study is toconfirm these findings and to determine if

there is some relationship with bladderaugmentation or with a ventriculoperitonealshunt.

MATERIAL AND METHODS

We included in this study 34 patients, witha mean age of 20.5 years (range 12-28).Patients were divided in 4 groups: 19 had anaugmented bladder (12 witha ventriculoperitoneal shunt and 7 without)