Electromotive drug administration EMDA: A novel method for the treatment of overactive neuropathic b

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Electromotive drug administration (EMDA) A
novel method for the treatment of overactive
neuropathic bladder with Botulinum toxin-A

• Abdol-Mohammad Kajbafzadeh, Laleh
  Montaser-Kouhsari, Hamed Ahmadi, Nima Baradaran,
  Lida Sharifi, Hamed Emami, Saman Shafaat talab,
  Shadi Abdar Esfahani
• Pediatric Urology Research Center
• Pediatrics Center of Excellence
• Tehran University of Medical Sciences

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Materials

• Randomized clinical trial (superiority trial)
  study (n20).
• Group I (n11) Received BTX-A (10 IU/kg) in
  sterile water via intravesical EMDA.
• (max current 10 mA , frequency 2500 Hz,
  duration15 min)
• Group II (n9) Received cystoscopic
  intradetrusor BTX-A (10 IU/kg) injection (40
  sites) under general anesthesia.
• Incontinence status and urodynamic assessments
  at baseline, 3, 9 and 12months of follow-up.

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Results
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Conclusions

• Intravesical EMDA of BTX-A is a safe and
  effective treatment modality in children with
  neurogenic detrusor overactivity (NDO).
• EMDA Noninvasive modality, performs on an
  outpatient basis, well accepted by patients,
  reduces therapeutic costs and obviates the need
  for additional treatment for at least one year
  due to its long-lasting efficacy.
• BTX-A iontophoresis is a more appropriate
  alternative for standard treatment in refractory
  NDO in comparison with intradetrusor BTX-A
  injection.
• To the best of our knowledge, this is the first
  report of intravesical EMDA of BTX-A in
  literature for the treatment of NDO.