Sacral neuromodulation and botulinum toxin for overactive neurogenic bladder in children

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 (R)) and botulinum toxin injection (Botox (R) 12 mg/kg or Dysport (R)) 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.