title: Urodynamic effects of propiverine in children and adolescents with neurogenic bladder: results of a prospective long-term study.
abstract: OBJECTIVE
  To evaluate prospectively the efficacy and tolerability of propiverine for long-term treatment of neurogenic detrusor overactivity (NDO) in children.
  
  
  METHODS
  17 children and adolescents with NDO (10 female, 7 male; average age at last consultation 13.0 years) were evaluated during long-term treatment with propiverine (0.8 mg/kg body weight/day). Outcome measurements included urodynamic parameters, continence, hydronephrosis and tolerability of propiverine.
  
  
  RESULTS
  Average follow-up was 3.6 years (range 2.0-5.9). The average maximum detrusor pressure was 33.2 ± 4.8 cmH(2)O and bladder compliance was 20.0 ± 5.4 ml/cmH(2)O at the last follow-up visit. Maximum cystometric bladder capacity (MCBC) within the normal range was attained in 11 patients; it was still reduced (average of 61% of expected MCBC) in the remaining 6. Incontinence occurred on average once per day. Hydronephrosis was classified for each renal unit separately: grade 0 was measured in 26 and 22 cases, grade 1 or 2 in 6 and 8 cases, grade 3 or 4 in 2 and 4 cases pre and post treatment, respectively. In 6/17 patients adjuvant intravesical oxybutynin was applied, in 4 out of these 6 patients more invasive procedures, such as untethering, augmentation cystoplasty or botulinum toxin injections, were necessitated. Propiverine monotherapy was well tolerated in 11/17 patients. No serious adverse events were encountered during the study period.
  
  
  CONCLUSIONS
  Long-term efficacy and tolerability of propiverine for NDO in children and adolescents is promising: clinically relevant improvements in key urodynamic outcomes were paralleled by improvements in incontinence score.
authors: Department of Urology, St. Hedwig Hospital, Medical School of Charité Universitätsmedizin, 10115 Berlin, Germany. h.schulte-baukloh@alexius.de
authors: Heinrich
authors: H
authors: Schulte-Baukloh
authors: Gerd
authors: G
authors: Mürtz
authors: Gert
authors: G
authors: Heine
authors: Paul
authors: P
authors: Austin
authors: Kurt
authors: K
authors: Miller
authors: Theodor
authors: T
authors: Michael
authors: Gerhard
authors: G
authors: Strugala
authors: Helmut H
authors: HH
authors: Knispel
mesh_terms: D000293:Adolescent; D001561:Benzilates / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015331:Cohort Studies; D003558:Cystoscopy / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000188:drug therapy*; D014549:Urinary Incontinence / Q000517:prevention & control; D014563:Urodynamics / Q000187:drug effects*
chemical_list: D001561:Benzilates; D018680:Cholinergic Antagonists; C015586:propiverine