title: Long-term intravesical oxybutynin chloride therapy in children with myelodysplasia.
abstract: OBJECTIVE
  We evaluated the clinical use of long-term intravesical oxybutynin chloride in the treatment of neurogenic bladder dysfunction in children with myelodysplasia who could not tolerate oral anticholinergics.
  
  
  METHODS
  We retrospectively reviewed the records of all patients recommended for intravesical oxybutynin chloride therapy. A total of 12 girls and 18 boys 1 to 17 years old was recruited for study. Oxybutynin chloride (5 mg.) was instilled 2 times daily and pretreatment cystograms were compared to followup urodynamic studies. Duration of therapy was 2 to 26 months (mean 13, median 12).
  
  
  RESULTS
  Mean total capacity plus or minus standard deviation increased from 209 +/- 103 to 282 +/- 148 ml. (p < 0.01), mean safe capacity increased from 157 +/- 105 to 234 +/- 147 ml. (p < 0.01) and mean age adjusted safe capacity increased from 76 +/- 36 to 115 +/- 62%. Of the 29 patients who were incontinent 3 (10%) achieved continence and 19 (65%) reported a decreased use of sanitary pads. None of the patients had systemic side effects related to intravesical treatment.
  
  
  CONCLUSIONS
  We believe that intravesical oxybutynin chloride is a viable treatment option for patients with myelodysplasia in whom oral therapy fails.
authors.affiliation: Department of Pediatric Urology, Children's Hospital of Michigan, Wayne State University, Detroit, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Painter
authors.forename: T S
authors.initials: TS
authors.lastname: Vates
authors.forename: T P
authors.initials: TP
authors.lastname: Bukowski
authors.forename: P
authors.initials: P
authors.lastname: Fleming
authors.forename: A L
authors.initials: AL
authors.lastname: Freedman
authors.forename: C A
authors.initials: CA
authors.lastname: Smith
authors.forename: R
authors.initials: R
authors.lastname: Gonzalez
authors.forename: A D
authors.initials: AD
authors.lastname: Perlmutter
mesh_terms: D000283:Administration, Intravesical; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage*; D009436:Neural Tube Defects / Q000150:complications* / Q000503:physiopathology; D010276:Parasympatholytics / Q000008:administration & dosage*; D011312:Pressure; D012189:Retrospective Studies; D013997:Time Factors; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics
chemical_list: D008333:Mandelic Acids; D010276:Parasympatholytics; C005419:oxybutynin