Detrusor overactivity in spina bifida: how long does it need to be treated?

Neurourology and Urodynamics
Elisabeth AbT P V M de Jong

Abstract

To determine whether a lasting therapeutic effect can be expected from long-term antimuscarinic therapy for neurogenic detrusor overactivity in spina bifida and to answer the question whether detrusor overactivity in spina bifida children with detrusor/sphincter dyssynergia is primarily based on the neuropathy or, in part, can be a secondary detrusor reaction to the functional urethral obstruction. Fifteen spina bifida patients, aged between 1 and 12 years, all on a regime of clean intermittent catheterisation (CIC) and oxybutynin since shortly after birth, underwent three consecutive urodynamic studies (UDS). One prestudy UDS for treatment control, one UDS after withdrawal of oxybutynin for 3-5 days and one UDS after reinstallment of oxybutynin treatment. Urodynamic results were compared concerning detrusor overactivity, cystometric bladder capacity, and compliance. Detrusor overactivity was seen in two patients on the prestudy UDS. After several days of withdrawal of oxybutynin overactivity was seen in 11 patients. After oxybutynin withdrawal, bladder compliance was within safe margins for two patients only, after reinstallment, safe vesical pressures were seen in 11 patients. The functional obstruction due to detrusor/sphinc...Continue Reading

References

Jan 1, 1973·Developmental Medicine and Child Neurology. Supplement·G D Stark
Aug 1, 1995·The Journal of Urology·L C FungB M Churchill
Jul 31, 2001·European Journal of Pediatrics·J D van GoolT P de Jong
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Citations

Apr 23, 2013·Journal of Pediatric Urology·Georgina MalakounidesSu-Anna Boddy
Mar 20, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Tom P V M de JongPieter Dik
Mar 1, 2010·Journal of Chiropractic Medicine·Keith R Kamrath
Mar 31, 2012·Neurourology and Urodynamics·L M O de KortS B Bauer
Apr 4, 2015·The Journal of Urology·Devon C Snow-LisyEarl Y Cheng
May 13, 2015·Nature Reviews. Urology·Paul W VeenboerTom P V M de Jong
Sep 16, 2017·Pediatric Research·Philip M IannacconeArun K Sharma
May 15, 2021·Curēus·Hesham H AbdelAziz, Mohamed H Gad

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