EARLY CYSTOMETROGRAMS CAN PREDICT THE RESPONSE TO INTRAVESICAL INSTILLATION OF OXYBUTYNIN CHLORIDE IN MYELOMENINGOCELE PATIENTS

Recent reported experiences with intravesical medications in neurogeni c bladder patients prompted us to evaluate this form of therapy in 28 myelomeningocele patients who could not tolerate oral anticholinergic agents or did not have adequate control on these agents. A pretreatmen t cystometrogram was performed followed by intravesical administration of oxybutynin chloride, with a repeat cystometrogram 3 hours later. P atients then began twice daily intravesical oxybutynin for a minimum o f 4 months. The mean bladder capacity increased by 41%, the mean intra vesical pressure decreased by 47% and compliance improved. Five patien ts achieved continence and 62% had less wetting while on intravesical therapy. The immediate posttreatment cystometrogram was predictive of the response to intravesical therapy on followup studies. Unfortunatel y, patient compliance was poor, with only 13 of the 28 patients remain ing on therapy for the duration of the study.