Abstract
To determine the effect of anticholinergic therapy in patients with detrusor instability and vesica ureteral reflux (VUR), a prospective clinical trial was designed including urodynamic evaluation in addition to routine X-Ray and laboratory studies; 69 neurologically normal children with 99 refluxing ureters aged 4 to 12 years were included. All patients received continuous prophylactic antibacterial chemotherapy. Initial urodynaidc findings distinguished 2 groups of patients; Group I: 27 children with 40 refluxing ureters and stable bladders, and Group II: 42 children with significant detrusor instability and 59 refluxing ureters. The latter received anticholinergics (propantheline bromide and imipramine hydrochloride).
Follow up evaluation (urodynamic and radiological)at 6 months revealed in Group I, reflux disappeared in 12/40 (30%) and improved in 2/40 (5%); in Group II, 30/42 pts.(41 refluxing ureters showed good clinical and urodynamic response to therapy; reflux disappeared in 27/41 refluxing ureters (66%) and improved in 10/41 (24%) whereas in 12/42 pts.(18 r.u.) not showing urodynamic response, reflux disappeared in 6/18 refluxing ureters (33%) and improved in 2/18 (11%). Preliminary data shows: a)Spontaneous reflux resolution rate in stable bladders of 30%; b)Higher reflux resolution rate, in children with detrusor instability who responded to anticholinergics, than in those who didn't; c)Detrusor instability may play a role in perpetuating primary VUR.
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Quesada, E., Podesta, M., Medel, R. et al. EFFECT OF ANTICHOLINERGIC THERAPY IN CHILDREN WITH PRIMARY VESICO URETERAL REFLUX AND DETRUSOR INSTABILITY. Pediatr Res 26, 164 (1989). https://doi.org/10.1203/00006450-198908000-00033
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DOI: https://doi.org/10.1203/00006450-198908000-00033