Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida

Objective To evaluate the incidence of side-effects of oral and intravesica l oxybutynin chloride in children with meningomyelocele (MMC) and a neuroge nic bladder. Patients and methods The study comprised 225 children with a neurogenic bla dder from MMC who were evaluated with urodynamic testing and voiding cystou rethrography to identify those at high risk of upper tract damage. In all, 101 children (mean age 4.2 years, range 0.25-10) had unco-ordinated detruso r-sphincter function and low compliance: they were treated with either oral or intravesical oxybutynin and clean intermittent catheterization. Results Of the 101 patients, 67 were treated with oral oxybutynin: in 11 th e treatment was discontinued because of the side-effects. The other 34 pati ents used both clean intermittent catheterization and intravesical oxybutyn in. In this group there were side-effects in six patients, including drowsi ness, hallucinations and cognitive changes. Conclusions Oral and intravesical oxybutynin is effective for managing neur ogenic bladder dysfunction, but intravesical administration is safer and be tter tolerated than oral oxybutynin in the treatment of children with MMC. However, adverse effects such as cognitive impairment can also occur in chi ldren treated with intravesical oxybutynin and these patients must be close ly monitored because these effects may differ from those with oral administ ration.