Painter K A, Vates T S, Bukowski T P, Fleming P, Freedman A L, Smith C A, Gonzalez R, Perlmutter A D
Department of Pediatric Urology, Children's Hospital of Michigan, Wayne State University, Detroit, USA.
J Urol. 1996 Oct;156(4):1459-62.
We evaluated the clinical use of long-term intravesical oxybutynin chloride in the treatment of neurogenic bladder dysfunction in children with myelodysplasia who could not tolerate oral anticholinergics.
We retrospectively reviewed the records of all patients recommended for intravesical oxybutynin chloride therapy. A total of 12 girls and 18 boys 1 to 17 years old was recruited for study. Oxybutynin chloride (5 mg.) was instilled 2 times daily and pretreatment cystograms were compared to followup urodynamic studies. Duration of therapy was 2 to 26 months (mean 13, median 12).
Mean total capacity plus or minus standard deviation increased from 209 +/- 103 to 282 +/- 148 ml. (p < 0.01), mean safe capacity increased from 157 +/- 105 to 234 +/- 147 ml. (p < 0.01) and mean age adjusted safe capacity increased from 76 +/- 36 to 115 +/- 62%. Of the 29 patients who were incontinent 3 (10%) achieved continence and 19 (65%) reported a decreased use of sanitary pads. None of the patients had systemic side effects related to intravesical treatment.
We believe that intravesical oxybutynin chloride is a viable treatment option for patients with myelodysplasia in whom oral therapy fails.
我们评估了长期膀胱内灌注氯奥昔布宁在治疗不能耐受口服抗胆碱能药物的脊髓发育不良儿童神经源性膀胱功能障碍中的临床应用。
我们回顾性分析了所有推荐接受膀胱内氯奥昔布宁治疗的患者的病历。共招募了12名女孩和18名年龄在1至17岁的男孩进行研究。每天膀胱内灌注2次氯奥昔布宁（5毫克），并将治疗前的膀胱造影与随访时的尿动力学研究结果进行比较。治疗持续时间为2至26个月（平均13个月，中位数12个月）。
平均总容量±标准差从209±103毫升增加到282±148毫升（p<0.01），平均安全容量从157±105毫升增加到234±147毫升（p<0.01），平均年龄校正安全容量从76±36%增加到115±62%。在29名尿失禁患者中，3名（10%）实现了控尿，19名（65%）报告使用卫生巾的次数减少。没有患者出现与膀胱内治疗相关的全身副作用。
我们认为，对于口服治疗失败的脊髓发育不良患者，膀胱内灌注氯奥昔布宁是一种可行的治疗选择。
