EXPERIENCE WITH INTRAVESICAL INSTILLATION THERAPY USING OXYBUTYNIN HYDROCHLORIDE IN PATIENTS WITH DETRUSOR HYPERREFLEXIA

Five patients with detrusor hyperreflexia and 2 patients with bladder instability were treated with intravesical oxybutynin hydrochloride 2- 3 times a day in a dosage of 5 mg per instillation. Of the 7 patients 5 were treated by intermitten clean self-catheterization, the remainin g 2 by indwelling Foley catheter. Incontinence could be eliminated com pletely in 2 of 6 patients, reduced in 3 of 6 patients, and 1 patient achieved diurnal continence. Under treatment, bladder capacity improve d by an average of 196 +/- 78 ml (p = 0.023), while intravesical press ure decreased by 11 +/- 4 cm H2O (p = 0.018) at maximal cystometric bl adder capacity and by 73 +/- 9 cm H2O (p = 0.004) during autonomous un inhibited detrusor contractions. Bladder compliance improved by an ave rage of 44 +/- 13 ml/cm H2O (p = 0.008). In patients with detrusor hyp erreflexia and incontinence performing self-catheterization, instillat ion of oxybutynin hydrochloride is an alternative to peroral medicatio n with the advantage of no or at least fewer side effects.