Prasad K V, Vaidyanathan S
Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Br J Urol. 1993 Nov;72(5 Pt 2):719-22. doi: 10.1111/j.1464-410x.1993.tb16255.x.
Oral administration of oxybutynin chloride is effective in increasing bladder capacity in patients with neurogenic bladder dysfunction who are practising clean intermittent catheterisation, but it is often associated with systemic side effects. The effect of intravesical instillation of oxybutynin chloride was studied in 14 patients who were practising clean intermittent catheterisation and in whom the maximum cystometric capacity was < 250 ml and/or vesical compliance < 5. A 5-mg tablet of oxybutynin chloride was crushed and suspended in 10 ml of boiled and cooled water and instilled into the bladder after emptying it completely; this was carried out thrice daily either by the patient or by his carer. During follow-up (6-12 months) no local or systemic side effects were observed and patient compliance was excellent in 12 patients, who showed an increase in maximum cystometric capacity and vesical compliance. One patient could not retain the drug intravesically because of reflex detrusor contraction and he was excluded from the study. One patient was lost to follow-up. The results suggest that the intravesical instillation of oxybutynin chloride is safe and effective in the treatment of selected patients with neurogenic bladder dysfunction whose bladder capacity is small and who are practising clean intermittent catheterisation.
对于采用清洁间歇性导尿的神经源性膀胱功能障碍患者，口服氯化奥昔布宁可有效增加膀胱容量，但常伴有全身副作用。对14例采用清洁间歇性导尿且最大膀胱测压容量<250 ml和/或膀胱顺应性<5的患者，研究了膀胱内灌注氯化奥昔布宁的效果。将1片5 mg的氯化奥昔布宁片剂碾碎，悬浮于10 ml煮沸并冷却的水中，在膀胱完全排空后注入膀胱；患者或其护理人员每天进行3次。在随访（6 - 12个月）期间，未观察到局部或全身副作用，12例患者的依从性良好，其最大膀胱测压容量和膀胱顺应性均有所增加。1例患者因逼尿肌反射性收缩无法在膀胱内保留药物，被排除在研究之外。1例患者失访。结果表明，膀胱内灌注氯化奥昔布宁对于膀胱容量小且采用清洁间歇性导尿的特定神经源性膀胱功能障碍患者的治疗是安全有效的。
