Treatment outcomes according to neuropathic bladder sphincter dysfunction type after treatment of oxybutynin chloride in children with myelodysplasia

被引:7
作者
Baek, Minki [1 ]
Kang, Jung Yoon [2 ]
Jeong, Jeongyun [3 ]
Kim, Dae Kyung [4 ]
Kim, Kwang Myung [5 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Urol, Seoul, South Korea
[2] Eulji Univ, Eulji Univ Hosp, Dept Urol, Sch Med, Seoul, South Korea
[3] Samsung Med Ctr, Ctr Hlth Promot, Seoul, South Korea
[4] Eulji Univ, Dept Urol, Sch Med, Eulji Univ Hosp, Taejon, South Korea
[5] Seoul Natl Univ, Coll Med, Seoul Natl Univ Hosp, Dept Urol, Seoul 110744, South Korea
关键词
Urinary bladder; Cholinergic antagonists; Spinal dysraphism; Urodynamics; Pediatrics; MULTICENTER OBSERVATIONAL COHORT; NEUROGENIC DETRUSOR OVERACTIVITY; INTERMITTENT CATHETERIZATION; PROPIVERINE HYDROCHLORIDE; MANAGEMENT; CAPACITY; MYELOMENINGOCELE; TOLERABILITY; ADOLESCENTS; EFFICACY;
D O I
10.1007/s11255-013-0423-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
We investigated the treatment outcomes according to neuropathic bladder sphincter dysfunction (NBSD) type after oral oxybutynin (OBT) treatment in children with NBSD caused by myelodysplasia. Among 334 pediatric patients who were diagnosed with NBSD caused by myelodysplasia, only children treated with oral OBT for more than 1 year with pre- and post-treatment urodynamic studies and dimercaptosuccinic acid (DMSA) were retrospectively reviewed. We compared pre- and post-treatment urodynamic parameters including maximum cystometric capacity (MCC), MCC/estimated bladder capacity (EBC), and compliance by NBSD type in children. We also compared renal scarring on pre- and post-treatment DMSA by NBSD type in children. Our study population was comprised of 81 children (45 boys and 36 girls), with a mean age of 4.2 +/- A 3.4 years. The mean follow-up duration was 4.5 (range 1.0-15.1) years. After OBT treatment, MCC was increased significantly in all types of NBSD from 110.3 +/- A 62.2 to 202.3 +/- A 103.9 ml (p < 0.05), compliance was significantly improved from 6.4 +/- A 6.1 to 11.1 +/- A 9.6 ml/cmH(2)O (p < 0.05), but MCC/EBC was slightly decreased from 75.2 +/- A 46.9 to 69.8 +/- A 33.3 % (p = 0.40). Sub-analyzed by NBSD type, the pre-treatment compliance of children with acontractile detrusor with spastic sphincter (n = 16) was markedly decreased compared with other types of NBSD. Acontractile detrusor with spastic sphincter demonstrated the worst renal deterioration on DMSA. Although increases in MCC/EBC were limited, oral OBT treatment markedly improved MCC and compliance in all NBSD types. Children who had acontractile detrusor with spastic sphincter had a relatively high probability of renal deterioration and required specific attention.
引用
收藏
页码:703 / 709
页数:7
相关论文
共 22 条
[1]   Efficacy, tolerability and safety of propiverine hydrochloride in comparison to oxybutynin in children with urge incontinence due to overactive bladder: Results of a multicentre observational cohort study [J].
Alloussi, Schahnaz ;
Muertz, Gerd ;
Braun, Reinhard ;
Gerhardt, Ulrich ;
Heinrich, Martina ;
Hellmis, Eva ;
Horn, Werner ;
Marschall-Kehrel, Daniela ;
Niklas, Kurt ;
Raabe, Michael ;
Roessler, Thomas ;
Seibt, Beatrix ;
Siemer, Stefan ;
Schultz-Lampel, Daniela ;
Walter, Heiko ;
Wiedeking, Burkhard ;
Alloussi, Saladin ;
Bock, Paul ;
Strugala, Gerhard ;
Madersbacher, Helmut .
BJU INTERNATIONAL, 2010, 106 (04) :550-556
[2]   Pharmacokinetics, metabolism, and saliva output during transidermal and extended-release oral oxybutynin administration in healthy subjects [J].
Appell, RA ;
Chancellor, MB ;
Zobrist, RH ;
Thomas, H ;
Sanders, SW .
MAYO CLINIC PROCEEDINGS, 2003, 78 (06) :696-702
[3]  
Aslan Ahmet R, 2002, Curr Opin Urol, V12, P473, DOI 10.1097/00042307-200211000-00005
[4]   Reference ranges for cystographic bladder capacity in children -: with special attention to vesicoureteral reflux [J].
Bael, An M. ;
Lax, Hildegard ;
Hirche, Herbert ;
Hjalms, Kelm ;
Tamminen-Mobius, Tytti ;
Van Hoeck, Koen M. ;
van Gool, Jan D. .
JOURNAL OF UROLOGY, 2006, 176 (04) :1596-1600
[5]   TREATMENT OF INFANTS WITH NEUROGENIC BLADDER DYSFUNCTION USING ANTICHOLINERGIC DRUGS AND INTERMITTENT CATHETERIZATION [J].
BASKIN, LS ;
KOGAN, BA ;
BENARD, F .
BRITISH JOURNAL OF UROLOGY, 1990, 66 (05) :532-534
[6]  
BAUER SB, 1990, UROL CLIN N AM, V17, P395
[7]   Prospective Open Label Study of Solifenacin for Overactive Bladder in Children [J].
Bolduc, Stephane ;
Moore, Katherine ;
Nadeau, Genevieve ;
Lebel, Sylvie ;
Lamontagne, Pascale ;
Hamel, Micheline .
JOURNAL OF UROLOGY, 2010, 184 (04) :1668-1673
[8]   Efficacy and Safety of Transdermal and Oral Oxybutynin in Children With Neurogenic Detrusor Overactivity [J].
Cartwright, Patrick C. ;
Coplen, Douglas E. ;
Kogan, Barry A. ;
Volinn, Weining ;
Finan, Eileen ;
Hoel, Gary .
JOURNAL OF UROLOGY, 2009, 182 (04) :1548-1554
[9]   Early start to therapy preserves kidney function in spina bifida patients [J].
Dik, P ;
Klijn, AJ ;
van Gool, JD ;
van Steenwijk, CCEDD ;
de Jong, TPVM .
EUROPEAN UROLOGY, 2006, 49 (05) :908-913
[10]   Oxybutynin in detrusor overactivity [J].
Diokno, Ananias ;
Ingber, Michael .
UROLOGIC CLINICS OF NORTH AMERICA, 2006, 33 (04) :439-+