LONG-TERM INTRAVESICAL OXYBUTYNIN CHLORIDE THERAPY IN CHILDREN WITH MYELODYSPLASIA

Purpose: We evaluated the clinical use of long-term intravesical oxybu tynin chloride in the treatment of neurogenic bladder dysfunction in c hildren with myelodysplasia who could not tolerate oral anticholinergi cs. Materials and Methods: We retrospectively reviewed the records of all patients recommended for intravesical oxybutynin chloride therapy. A total of 12 girls and 18 boys 1 to 17 years old was recruited for s tudy. Oxybutynin chloride (5 mg.) was instilled 2 times daily and pret reatment cystograms were compared to followup urodynamic studies. Dura tion of therapy was 2 to 26 months (mean 13, median 12). Results: Mean total capacity plus or minus standard deviation increased from 209 +/ - 103 to 282 +/- 148 mi. (p < 0.01), mean safe capacity increased from 157 +/- 105 to 234 +/- 147 mi. (p < 0.01) and mean age adjusted safe capacity increased from 76 +/- 36 to 115 +/- 62%. Of the 29 patients w ho were incontinent 3 (10%) achieved continence and 19 (65%) reported a decreased use of sanitary pads. None of the patients had systemic si de effects related to intravesical treatment. Conclusions: We believe that intravesical oxybutynin chloride is a viable treatment option for patients with myelodysplasia in whom oral therapy fails.