Alfuzosin in the treatment of high leak-point pressure in children with neurogenic bladder.
OBJECTIVE
To decrease the detrusor leak-point pressure (LPP) of > 40 cmH2O in children with a neurogenic bladder, using the alpha1-adrenergic blocking agent alfuzosin.


METHODS
Videocystometry was used to measure the detrusor LPP and several other variables before and 3 weeks after the oral administration of alfuzosin (2.5-7.5 mg/day) in 17 children (mean age 6.3 years) with an upper motor neurone lesion.


RESULTS
The mean (sd) detrusor LPP decreased from 68 (37) to 46 (31) cmH2O (P < 0.01), reflex volume (defined as the volume at the first uninhibited bladder contraction of > 15 cmH2O) increased from 78 (69) to 112 (118) mL (+ 44%), bladder compliance increased from 9.3 (6.1) to 19.6 (14.6) mL/cmH2O (+ 111%), maximal vesical pressure decreased from 84 (40) to 70 (47) cmH2O (- 17%), and the mean number of uninhibited bladder contractions decreased from 6.3 to 3.5 (- 44%). The therapy was well tolerated; side-effects were rare and not severe. Intermittent catheterization could be avoided in six children.


CONCLUSIONS
Alfuzosin decreases the detrusor LPP in children with a neurogenic bladder caused by an upper motor neurone lesion, significantly and therapeutically, and should be considered as an alternative or addition to intermittent catheterization and anticholinergic drugs in selected patients.
Schulte-Baukloh
H
H
St. Hedwig Hospital (Teaching Hospital), Free University of Berlin, Berlin, Germany. hschultebaukloh@hotmail.com
Michael
T
T
Miller
K
K
Knispel
H H
HH
D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011312:Pressure; D011799:Quinazolines / Q000627:therapeutic use*; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014741:Video Recording
D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; C047638:alfuzosin