It lasts for about six months. Botox only relaxes the specific muscles it is injected into. The surrounding muscles work normally. Doctors are increasingly using Botox bladder injections to treat muscular spasms. The results have been positive, with minor or no complications.
Based on reported studies, Botox bladder injections are safe to use in children with bladder problems and bladder disorders. Doctors are still testing Botox injections for bladder problems in children. So far, all side effects are uncommon and fairly minor. As the procedure is still relatively new, there is little information available concerning long-term side effects.
Key Points Botox bladder injections can treat children who have trouble controlling their urine incontinence. Botox injections relax the bladder muscles so it does not contract too frequently, and gives the child more control over when they urinate. Studies show Botox bladder injections are safe, with minor or no complications It takes a few days for the Botox to work. It lasts for six months. The doctor will run follow-up tests to blog augmentation mammaire lyon forum the bladder and see if the injections are helping.
These include: Neurogenic bladder Idiopathic detrusor overactivity Detrusor sphincter dyssynergia Your child's doctor may suggest Botox injections if medicines or other forms of therapy do not work. What is Botox? What happens during the procedure? Botox bladder injections are a minor procedure. It takes about 30 minutes. Before the procedure, the doctor will give your child a general anesthetic. When your child is asleep, the doctor places a small tube containing a camera cystoscope into your child's bladder.
A thin tube, called the urethra, connects the bladder to the genitals. The surgeon passes the cystoscope through the urethra. The urethra is checked before the injection. The surgeon then injects a thin needle containing Botox through the cystoscope. Dermal fillers can be placed in the cheeks, chin, lips, nasal folds and the bridge of the nose.
Fillers can also be applied to the earlobes for plumping and acne scars to make them less visible. Wooming offers Voluma and Belotero brand fillers. Visit Dr. An alternative to surgery, botox and fillers allow activities to be resumed immediately after the procedure. As an alternative, localization by ultrasound has been developing over the last few years.
Recent studies have shown its interest as concerns the intramuscular injections performed in treatment of spasticity in children. Moreover, a study by Py et al. Evaluation of the effectiveness of botulinum toxin injections in the lower limb muscles of children with cerebral palsy. By the same token, clinical experience has shown that localization by ultrasound appears less painful than localization by electrostimulation.
However, scarcely any studies have objectified this clinical fact, and we have found no published work comparing the different localization techniques in terms of the pain they may cause. Our hypothesis is that when electrostimulation is not applied, intramuscular injection is perceived as less painful. The objective of this study has consequently consisted of assessing the levels of pain occasioned by injections of botulinum toxin in children according to the localization technique employed, namely electrostimulation or ultrasound.
This is an open monocentric prospective study covering the period from May to October The inclusion criteria were: any child less than 18 years of age undergoing a botulinum toxin injection as treatment for spasticity of the lower limbs. The exclusion criteria were: more than 18 years of age, anatomical localization, insufficient data, injection at the level of the upper limbs. We only included injections carried out on the lower limbs; injections carried out on the upper limbs were excluded so as to obtain localization of targeted muscles presenting as much homogeneity as possible and thereby avoid introducing a bias through which muscle localization would depend on perception of the injection as painful.
For each child treated, an assessment sheet was filled out. The recorded data included: mode of pain assessment self-evaluation or hetero-evaluation and demography, as well as the localization technique applied, the type of toxin used, the concentration, the total dose, the number of muscles, the number of injection sites, and the methods of distraction and premedication.
The localization technique was chosen independently of clinical context according to the availability of the ultrasound apparatus on the day of injection. The ethics committee of the Angers university hospital gave its approval to this observational study. The injection was started subsequent to at least 3 minutes of inhalation aimed at achieving optimal sedation. Use of these means of treatment was decided upon according to the age of the child and the degree to which the physician was familiar with him or her.
The different medical procedures, methods of distraction and therapeutic drugs were all indicated in the patient's medical records. Injections were performed by an experienced injector accustomed to applying the two localization techniques.
The probe was 9 L. To apply this localization technique, two physicians were needed, one to inject the botulinum toxin and the other to hold the ultrasound probe and guide localization of the targeted muscle. In order to avoid any positioning in a blood vessel, only once the needle had been correctly visualized in the targeted muscle and only after aspiration was the product injected. The same types of needles were used for botulinum toxin injection, regardless of the localization technique being implemented.
When the injecting physicians judged that localization by ultrasound or by electrostimulation alone did not adequately discriminate the targeted muscle, they were allowed to additionally apply the other technique. Assessment was based on two scales involving self-evaluation or hetero-evaluation: the visual analog scale VAS used by the child or the accompanying party and the behavior-based FLACC scale.
Click here to see the Library ]. On the back of the ruler, ratings were scaled from 0 to Overall assessment of the pain experienced during the session was given by the child just after it ended. The parents were likewise asked to evaluate the pain their child had felt, particularly when, on account of age or communication disorders, it was impossible for the child himself to provide the assessment. When the parents were not present, evaluation was carried out by a third party attending the sessions and familiar with the child.
If both the child and another person assessment had been performed, then, we used the VAS scale of the child in our analysis. The reliability and validity of the Face, Legs, Activity, Cry. When there were several injections during a session, evaluation pertained to the most painful moment. The variables were expressed in means with standard deviations for the quantitative values and in percentages for the qualitative values. As the distributions of the quantitative variables were not always Gaussian, we also calculated the median, the minimum and maximum values and the confidence interval.
If the P value was less than 0. SAS 9. One hundred and fifty-five sessions of intramuscular botulinum toxin injection took place from May to October The 40 injection sessions involving the upper limbs were eliminated from consideration, as were 5 sessions with patients more than 18 years of age, 2 in which the data were insufficient, and 1 because localization had been exclusively anatomical. The remaining sessions were analyzed. Average age of the children was An average of 5.
Forty-three percent of the subjects were girls. The groups in which localization was obtained by either ultrasound or electrostimulation did not significantly differ in terms of age, number of injection sites, average duration of injection, volume injected or pre-analgesic techniques applied. As regards hydroxyzine and paracetamol, frequency of use was too low to carry out statistical analysis.
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