title: Histopathologic and Urodynamic Effects of the Anticholinergic Drugs Oxybutynin, Tolterodine, and Trospium on the Bladder.
abstract: OBJECTIVE
  This study aimed to evaluate the effects of intravesical instillation of the anticholinergic drugs oxybutynin, tolterodine, and trospium on bladder capacity and histopathological changes in the bladder mucosa.
  
  
  METHODS
  The study included 20 male New Zealand white rabbits that were randomly allocated to four groups of five. In the oxybutynin, tolterodine, and trospium groups, the drugs used were 1 mg/kg of crushed tablet mixed with 5 mL of saline, instilled intravesically once per day for 4 weeks. The control group was administered only 5 mL of saline once per day for 4 weeks. Urodynamic measurement of the bladder was made before and after treatment. At the end of the treatment the animals were killed and the bladders were evaluated histopathologically.
  
  
  RESULTS
  There were no significant differences between pre- and post-treatment bladder capacity in any of the groups (P > 0.05). Histopathological evaluation showed that the mucosal epithelium was intact and there was minor inflammation in the control group and oxybutynin group (P > 0.05), whereas there was destruction of the mucosal epithelium and findings of diffuse inflammation in the tolterodine (P = 0.014) and trospium (P = 0.014) groups.
  
  
  CONCLUSIONS
  Intravesical oxybutynin treatment was observed to be safe; however, a single daily dose of oxybutynin may not be sufficient to increase bladder capacity. Intravesical use of trospium and tolterodine at high doses caused epithelial destruction and diffuse inflammation in the bladder mucosa. The irritation associated with epithelial destruction and inflammation prevented an increase in bladder capacity.
authors.affiliation: Department of Urology, Batman State Hospital, Batman, Turkey.
authors.forename: Seyfettin
authors.initials: S
authors.lastname: Orgen
authors.affiliation: Department of Urology, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Deliktas
authors.affiliation: Department of Urology, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Sahin
authors.affiliation: Department of Urology, School of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Gedik
authors.affiliation: Department of Histology, School of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Nergis
mesh_terms: D000818:Animals; D001561:Benzilates / Q000494:pharmacology*; D008297:Male; D008333:Mandelic Acids / Q000494:pharmacology*; D018727:Muscarinic Antagonists / Q000494:pharmacology*; D009662:Nortropanes / Q000494:pharmacology*; D011817:Rabbits; D011897:Random Allocation; D000068737:Tolterodine Tartrate / Q000494:pharmacology*; D001743:Urinary Bladder / Q000187:drug effects*; D064804:Urological Agents / Q000494:pharmacology*; D019459:Urothelium / Q000187:drug effects
chemical_list: D001561:Benzilates; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D009662:Nortropanes; D064804:Urological Agents; C003330:trospium chloride; D000068737:Tolterodine Tartrate; C005419:oxybutynin
keywords: anticholinergic drugs; bladder capacity; histopathology; intravesical instillation; rabbits