[Long-term efficacy of anticholinergic and alpha-blockader drugs on the detrusor muscle in children with myelomeningocele].
Pharmacological agents, essentially anticholinergic and alpha-blocking drugs, occupy an important place in the stabilization of congenital neurogenic bladders. In actual fact, the functional characteristics of the detrusor, contractility, compliance and functional capacity, are important factors in the prognosis of these neurogenic bladders, both for the future of the upper urinary tract and for the possibilities of continence. This behaviour of the detrusor may be pharmacologically modified not only by anticholinergic drugs, but also by alpha-blockers due to the adrenergic innervation of foetal bladders by short neurones. This study compared the activity of these 2 drugs prescribed separately over a minimal period of 2 years to 54 children with congenital neurogenic bladder. The amplitude of vesical contraction was reduced in about 75% of cases with both drugs, but this result was obtained more rapidly with anticholinergic drugs than with alpha-blockers. No escape phenomenon over time was observed. Anticholinergic drugs were more effective on phasic contractions while alpha-blockers were more effective on rhythmic contractions. In contrast, they had an insignificant action on hypertonia. The increase in functional vesical capacity was 4 times greater with anticholinergic drugs than with alpha-blockers, possibly because of a simultaneous reduction in peripheral resistance with alpha-blockers.
D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology*; D000328:Adult; D002648:Child; D004341:Drug Evaluation; D005500:Follow-Up Studies; D006801:Humans; D008591:Meningomyelocele / Q000150:complications*; D009119:Muscle Contraction / Q000187:drug effects; D010276:Parasympatholytics / Q000494:pharmacology*; D011312:Pressure; D013997:Time Factors; D001743:Urinary Bladder / Q000187:drug effects* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000151:congenital* / Q000503:physiopathology
D000317:Adrenergic alpha-Antagonists; D010276:Parasympatholytics
Efficacité à long terme des médicaments anticholinergiques et alpha-bloquants sur le détrusor d'enfants atteints de myélo méningocèle.