The role of imipramine therapy in bladder exstrophy after bladder neck reconstruction.
OBJECTIVE
To assess the role of imipramine therapy after bladder neck reconstruction in patients with bladder exstrophy.


METHODS
Seventeen children with bladder exstrophy who achieved partial continence after bladder neck reconstruction received imipramine (1.5-2 mg/kg body weight) for a mean duration of 9.5 months. Assessment before and after therapy included an objective classification of the continence status and artificial slow-fill cystometry.


RESULTS
Eleven of the 17 patients had a good clinical response to imipramine, with an increase in the continent period to > 2 h, and in nocturnal continence. The urodynamic findings showed a significant improvement in the capacity, end-fill pressure, uninhibited contractions and '20 below' capacity. Only minor side-effects of the drug were reported.


CONCLUSIONS
Imipramine has a role in patients who achieve partial continence after reconstruction, and who have a moderately small capacity bladder with poor compliance and uninhibited contractions.
Dave
S
S
The Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Grover
V P
VP
Agarwala
S
S
Mitra
D K
DK
Bhatnagar
V
V
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001746:Bladder Exstrophy / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D014563:Urodynamics; D014839:Vomiting / Q000139:chemically induced
D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine