Modified Intravesical Oxybutynin Chloride Therapy in Children with Neurogenic Bladder: a Ten-year Follow-up

Hypothesis / aims of study Children with spinal cord disorders can present with neurogenic bladder, a condition in which the bladder partly or completely loses its ability to store urine and void at low pressure. A bladder with low compliance may cause urinary incontinence, which negatively impacts quality of life and renal function. Long-term high pressure neurogenic bladder can increase the risk of deterioration in renal function. Anti-muscarinic pharmacotherapy with clean intermittent catheterization (CIC) is currently considered one of the most effective treatments for these patients. However, some patients do not respond to oral medication or have unacceptable adverse events, e.g., dry mouth, constipation, drowsiness, and cognitive dysfunctions, which may result in medical withdrawal for these patients. Intravesical oxybutynin is an effective treatment with less adverse events compared with oral medication. There is increasing evidence that intravesical oxybutynin is an effective therapy against neurogenic bladder [1]. However, an important issue with this treatment is retention of the solution in the bladder. A previous study reported that intravesical oxybutynin with hydroxypropylcellulose (HPC) can effectively treat children with neurogenic bladder [2]. In the present study, we report on the efficacy, safety, and side effects of long-term modified intravesical oxybutynin therapy in children with neurogenic bladder.