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Effect of phenylpropanolamine on incontinence in children with neurogenic bladders. A double-blind crossover study
Insights
Phenylpropanolamine, an alpha-adrenoceptor agonist, helped reduce detrusor hyperactivity and improve continence in children with neurogenic bladder due to myelodysplasia. However, it did not fully restore bladder control.
Area of Science:
- Pediatric Urology
- Neurogenic Bladder Dysfunction
- Pharmacology
Background:
- In children with myelodysplasia and sacral spinal cord lesions, detrusor hyperactivity and dyssynergic urethral function are primary causes of incontinence.
- Current pharmacological treatments for neurogenic bladder dysfunction primarily involve anticholinergics and alpha-adrenoceptor antagonists.
Purpose of the Study:
- To investigate the effects of phenylpropanolamine, an alpha-adrenoceptor agonist, on urodynamic parameters and incontinence in children with myelodysplasia.
- To evaluate the efficacy of phenylpropanolamine in managing neurogenic bladder incontinence.
Main Methods:
- A double-blind crossover trial was conducted involving 10 pediatric patients.
- Urodynamic parameters and incontinence were assessed.
- Plasma concentrations of phenylpropanolamine were measured using gas chromatography-mass spectrometry.
Main Results:
- Phenylpropanolamine demonstrated a reduction in detrusor hyperactivity.
- Improvements in continence were observed in the patients treated with phenylpropanolamine.
- The observed effect on continence was not sufficient to achieve complete dryness.
Conclusions:
- Phenylpropanolamine shows potential as a treatment for reducing detrusor hyperactivity in pediatric neurogenic bladder.
- While phenylpropanolamine can improve continence, further therapeutic strategies may be needed for complete incontinence management in this population.
Abstract:
In children with myelodysplasia and a low-level spinal cord lesion (low lumbar-sacral), detrusor hyperactivity together with dyssynergic urethral function forms the main pathophysiological basis for incontinence. Pharmacological treatment of incontinence due to neurogenic bladder dysfunction has been tried, mainly with anticholinergics and alpha-adrenoceptor antagonists. In this study, the effects of the alpha-adrenoceptor agonist phenylpropanolamine on urodynamic parameters and incontinence were investigated in 10 patients. Effects on incontinence were evaluated in a double-blind crossover trial. Plasma concentrations of phenylpropanolamine were measured by means of gas chromatography-mass spectrometry. Phenylpropanolamine reduced detrusor hyperactivity and improved continence, but the effect was not so pronounced as to make the patients continent.