Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida.
OBJECTIVE
To evaluate the incidence of side-effects of oral and intravesical oxybutynin chloride in children with meningomyelocele (MMC) and a neurogenic bladder.


METHODS
The study comprised 225 children with a neurogenic bladder from MMC who were evaluated with urodynamic testing and voiding cysto-urethrography 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 detrusor-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 the treatment was discontinued because of the side-effects. The other 34 patients used both clean intermittent catheterization and intravesical oxybutynin. In this group there were side-effects in six patients, including drowsiness, hallucinations and cognitive changes.


CONCLUSIONS
Oral and intravesical oxybutynin is effective for managing neurogenic bladder dysfunction, but intravesical administration is safer and better tolerated than oral oxybutynin in the treatment of children with MMC. However, adverse effects such as cognitive impairment can also occur in children treated with intravesical oxybutynin and these patients must be closely monitored because these effects may differ from those with oral administration.
Ferrara
P
P
Department of Paediatrics, Catholic University, Rome, and Bassini Hospital, Milan-Bicocca University, Cinisello Balsamo, Milan, Italy. pietro.ferrara@mailcity.com
D'Aleo
C M
CM
Tarquini
E
E
Salvatore
S
S
Salvaggio
E
E
D000283:Administration, Intravesical; D000284:Administration, Oral; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced; D005483:Flushing / Q000139:chemically induced; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D007223:Infant; D008333:Mandelic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D008591:Meningomyelocele / Q000150:complications*; D012189:Retrospective Studies; D012894:Sleep Stages / Q000187:drug effects; D016135:Spinal Dysraphism / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000209:etiology; D014563:Urodynamics
D018680:Cholinergic Antagonists; D008333:Mandelic Acids; C005419:oxybutynin