Cystometric response to propantheline in detrusor hyperreflexia: therapeutic implications

We studied 42 patients with urinary incontinence who demonstrated uninhibited detrusor contractions during cystometry. Each patient underwent urodynamic evaluation before and after the parenteral administration of propantheline bromide. Of these 42 patients 33 (79 per cent) had a positive response to propantheline: total abolition of uninhibited bladder contractions or 200 per cent increase in bladder capacity. Of these 33 patients 26 were treated with the oral drug and all but 1 had complete clinical response. Urinary retention occurred in half of the patients. These patients were managed with intermittent self-catheterization in addition to oral propantheline. None of the patients who failed to respond to the parenteral medication had a favorable response to the orally administered drug.