Continence training of children with neurogenic bladder and detrusor hyperactivity: effect of atropine.

Recording of the intravesical pressure throughout the filling phase in children with low lumbar and high sacral levels of myelodysplasia showed detrusor hyperactivity which could be inhibited by anticholinergic medication in a dose-dependent manner under experimental conditions. Atropine as treatment for urinary incontinence during everyday activity was remarkably effective when given parenterally. Orally administered atropine was associated with 50-100% improvement of incontinence in six of 9 patients and 35-45% in the remaining three patients. Successful treatment with anticholinergic drugs requires careful selection of patients, including recording of the filling-phase intravesical pressure. Only in patients with detrusor hyperactivity is a good result of such treatment to be expected.