Related Experiment Videos
The use of intravesical oxybutynin chloride in children with neurogenic bladder
1State University of New York, Buffalo School of Medicine, Department of Urology, Children's Hospital of Buffalo.
Insights
Intravesical oxybutynin chloride effectively treated urinary incontinence in children with neurogenic bladder. This therapy improved bladder capacity and reduced filling pressures, avoiding surgery for many patients.
Area of Science:
- Pediatric Urology
- Neurology
- Pharmacology
Background:
- Neurogenic bladder, often due to myelomeningocele, causes urinary incontinence refractory to standard treatments.
- Oral anticholinergic medications and intermittent catheterization may not be sufficient for managing complex bladder dysfunction.
Purpose of the Study:
- To evaluate the efficacy and safety of intravesical oxybutynin chloride for treating urinary incontinence in children with neurogenic bladder.
- To assess the impact of intravesical oxybutynin chloride on bladder capacity and filling pressures.
Main Methods:
- Ten children with neurogenic bladder and refractory incontinence received intravesical oxybutynin chloride (5 mg in 10 cc sterile saline) twice daily.
- Urodynamic studies were performed to measure bladder capacity and filling pressures before and after treatment.
Main Results:
- 50% of children achieved complete daytime and nighttime continence.
- 30% achieved daytime continence only.
- Urodynamic studies showed up to a 335% increase in bladder capacity and a 63% decrease in maximum filling pressures.
- No local or systemic side effects were reported.
Conclusions:
- Intravesical oxybutynin chloride is a safe and effective treatment for urinary incontinence in children with neurogenic bladder.
- This therapy can significantly improve bladder function and potentially avoid the need for surgical bladder augmentation.
Abstract:
Intravesical oxybutynin chloride was administered to 10 children with neurogenic bladder (myelomeningocele in 9 and imperforate anus in 1) and urinary incontinence refractory to regimens of intermittent catheterization and oral anticholinergic medication. Therapy consisted of instillation of 5 mg. crushed oxybutynin chloride in 10 cc sterile saline twice daily. Of the children 5 (50%) became completely dry day and night, 3 (30%) achieved daytime continence alone, and 2 did not improve clinically and remained in diapers. Urodynamic study revealed increases in bladder capacity up to 335% over baseline and decreases of maximum filling pressures to 63%. No local or systemic side effects were noted. Surgical bladder augmentation was avoided in those who clinically responded to this therapy.