Abu Dhabi: A new technique known as botulinum toxin A injection was used on three children with urinary problems for the first time in the UAE at Shaikh Khalifa Medical City (SKMC).

Botulinum toxin A was previously used at SKMC only for adults, but this approach also offers a reliable and minimally invasive alternative for the treatment of urinary incontinence in children with neurogenic bladders.

Dr Mario Patricolo, Consultant paediatric surgeon and paediatric urologist at SKMC performed the first procedures of botulinum toxin A injection into the bladders of the three children.

Successful treatment

Patricolo explained that Botulinum toxin A has been used internationally for the successful treatment of urinary incontinence and overactive bladders when conventional medications and other therapies are ineffective.

"Botulinum toxin A injection is an ideal treatment method for pediatric patients with bladder problems caused by nerve-related problems such as over-activity, congenital abnormalities of the spine [spina bifida], or traumatic spinal injuries as well as bladder dysfunction unrelated to the nervous system," said the doctor.

The use of botulinum toxin A has also been applied in some cases with functional vesical obstruction when the bladder and the bladder sphincter do not function in a coordinated manner.

The intravesical injection of botulinum toxin A is an endoscopic technique therefore, it can be approached through a telescope with very low risk of side effects. The procedure is performed in a one day operation with the child going home with his or her family on the same day as the procedure. The beneficial effects last eight to 12 months in children and can lead to reduction or interruption of otherwise needed oral medications.

"It is worth mentioning that these first three cases have been reviewed at their follow-up appointments, and all have experienced improvement of their urinary continence," said Patricolo.

Dr Scott Strong, Acting CEO of SKMC said that minimally invasive approaches such as the botulinum toxin A injections have well positioned SKMC as an institution that allows its surgeons to advance the standard of care for their patients.

SKMC has performed during the first six months of 2008 around 3,400 minor and major procedures in addition to 250 cardiac surgeries for pediatric patients and adults.

More cases are already scheduled for botulinum toxin A injection and the results of this technique will be discussed during an international conference on the Neurogenic Bladder, organised by SKMC and Abu Dhabi Health Services Company that will take place in March 2009.

Achievement: Facility among top three

Shaikh Khalifa Medical City (SKMC), located in Abu Dhabi operating under the management of Cleveland Clinic, was named as one of the top three hospitals by US News and World Report.

SKMC is owned by the Abu Dhabi Health Services Company recently established to oversee operations of all public hospitals in the Emirate.

SKMC consists of a 550-bed Acute Care Hospital and 14 specialised outpatient clinics accredited by the Joint Commission International and manages a 120-bed Behaviour Sciences Pavilion, a 90-bed Rehabilitation Centre, nine primary health care centres and two dental centres are distributed over the city of Abu Dhabi.