Published online Oct 31, 2007.
https://doi.org/10.4111/kju.2007.48.10.1064
Efficacy and Tolerability of Extended-release Oxybutynin in Children with a Neurogenic Bladder
Abstract
Purpose
The aim of this study was to investigate the efficacy and tolerability of extended-release oxybutynin (oxybutynin ER) in children with a neurogenic bladder.
Materials and Methods
Fifty-four patients (21 myelomeningocele and 33 lipomyelomeningocele) with a neurogenic bladder were enrolled in the study. We reviewed the medical records and performed a telephone interview. The treatments were changed from immediate-release oxybutynin (oxybutynin IR) or other anticholinergics to oxybutynin ER from August to December 2006. The mean age of the study patients was 11.1 years (range 4 to 18 years) and the mean body weight was 37.9kg (range 16.2 to 72.0kg). All patients were asked about the effectiveness, side effects and compliance with the medication. The number of voids, volume of urine per void or clean intermittent catheterization (CIC) and number of incontinence episodes were also evaluated.
Results
The mean duration of oxybutynin ER treatment was 16.3 weeks (range 7-25 weeks). Twenty-six patients (48.1%) responded they had improvement in voiding symptoms. Among the patients, there was a significant reduction in the number of incontinence episodes (from 3.3 to 1.3, p<0.001) with the change in medications. The number of voids or CIC per 24 hours and the maximum volume of urine per void or CIC did not show a significant change. Another twenty-eight patients (51.9%) responded that the improvements were maintained. Among these patients, there were no significant changes of the medications. Only five patients (9.3%) changed their medication because of the side effects.
Conclusions
The results of this study showed that the extended-release oxybutynin was effective and well tolerated in children with a neurogenic bladder.
Fig. 1
The efficacy of extended-release oxybutynin. In this group, the patients said they experienced improvement in efficacy after the medication was changed from other anticholinergics to the extended-release oxybutynin (p>0.05 except incontinence).
Fig. 2
The efficacy of extended-release oxybutynin. In this group, the patients said they experienced maintenance of the improved efficacy after the medication change from other anticholinergics to the extended-release oxybutynin (p>0.05).
Fig. 3
Compliance with extended-release oxybutynin.
Fig. 4
Flow chart of the medication changes.
Table 1
Side effects of extended-release oxybutynin
Table 2
Comparison of efficacy and side effects of the extended-release oxybutynin (oxybutynin ER) between the patients who could use immediate-release oxybutynin (oxybutynin IR) and the patients who could not
References
-
Kasabian NG, Bauer SB, Dyro FM, Colodny AH, Mandell J, Retik AB. The prophylactic value of clean intermittent catheterization and anticholinergic medication in newborns and infants with myelodysplasia at risk of developing urinary tract deterioration. Am J Dis Child 1992;146:840–843.
-
-
Appel RA. Oxybutynin. The clinical experience. Contemp Urol 1991;3:60–67.
-
-
Massad CA, Kogan BA, Trigo-Rocha FE. The pharmacokinetics of intravesical and oral oxybutynin chloride. J Urol 1992;148:595–597.
-
-
Kasabian NG, Vlachiotis JD, Lais A, Klumpp B, Kelly MD, Siroky MB, et al. The use of intravesical oxybutynin chloride in patients with detrusor hypertonicity and detrusor hyperreflexia. J Urol 1994;151:944–945.
-
-
Nijman RJ. Classification and treatment of functional incontinence in children. BJU Int 2000;85 Suppl 3:37–42.
-
-
Gupta S, Sathyan G. Pharmacokinetics of an oral once-a-day controlled-release oxybutynin formulation compared with immediate release oxybutynin. J Clin Pharmacol 1999;39:289–296.
-
-
Autret E, Jonville AP, Dutertre JP, Bertiere MC, Robert M, Averous M, et al. Plasma levels of oxybutynin chloride in children. Eur J Clin Pharmacol 1994;46:83–85.
-