INTRAVESICAL OXYBUTININ CHLORIDE IN CHILDREN WITH INTERMITTENT CATHETERIZATION - SONOGRAPHIC FINDINGS

The sonographic findings in the bladder are presented in four children with myelomeningocele and neurogenic dysfunction of the bladder, who were treated with intermittent self-catheterization and intravesical o xybutinin chloride. All were referred for routine sonography of the ur inary tract. Each had infused a crushed tablet of oxybutinin chloride intravesically 30-120 min before the examination. In two children, bri ghtly echogenic, non-shadowing particles were suspended in the bladder urine. In one of these, the particles swirled giving the impression o f a ''snowstorm''; in the other, most of the particles gradually settl ed forming an irregular clump on the bladder base. In the remaining tw o children, the urine appeared diffusely hazy with innumerable tiny pa rticles giving the impression of a fine mist filling the bladder. The sonographic appearance of the urine in the bladder after intravesical instillation of crushed tablets can be dramatic and can simulate pus, blood, fungus, or other debris in the bladder lumen. In the absence of clinical symptoms or hematuria, a history of recent infusion of medic ation into the bladder should be sought.