EFFECT OF ORAL OXYBUTYNIN CHLORIDE ON URO DYNAMIC PARAMETERS IN CHILDREN SUFFERING FROM MYELOMENINGOCELE WITH DETRUSOR HYPERREFLEXIA

Effect of Oral Oxybutynin Chloride on Urodynamic Parameters in Childre n Suffering from Myelomeningocele with Detrusor Hyperreflexia: The eff ect of oral oxybutynin chloride (OH) on urodynamic parameters was inve stigated in 30 children (14 m, 16 f; age 11 months to 15 years, mean a ge 4.5 years) with myelomeningocele (MMC) and detrusor hyperreflexia. The dose of OH was 0.2-0.3 mg/kg TID-QID with all patients set on conc omitant intermittent catheterization. Patients were reevaluated urodyn amically within 3 months while on OH medication. Mean bladder capacity increased from 132 +/- 92 ml to 190 +/- 95 ml (+ 44%; p < 0.01). Detr usor pressure at maximum capacity decreased from 44 +/- 34cm H2O to 33 +/- 25 cm H2O (-25%; p < 0.05). Detrusor compliance increased from 6. 7 +/- 6.1 ml/cm H2O to 15.4 +/- 13.9 ml/cm H2O (+130%; p < 0.01). Impr ovement of urodynamic parameters correlated with improvement of contin ence. In one case intravesical instillation of OH was initiated becaus e of side effects from oral medication. In a followup interval of at l east 2 years an effective protection of renal function was achieved in 29 out of 30 children (97 %) with conservative therapy alone. We conc lude that treatment with oral OH and intermittent catheterization, bas ed on urodynamic findings, is effective and safe in children with MMC and detrusor hyperreflexia. Therefore, it should be started early when indicated by urodynamic findings.