Twelve patients with detrusor hypercontractility secondary to spinal cord lesions were treated with intravesical atropine sulphate. Five patients expelled the solution almost immediately. In the seven patients who retained the solution the cystometric capacity increased by a mean of 301 ml (P < 0.01). The volume at which an unstable contraction occurred increased by a mean of 190 ml (P < 0.05) and the volume at which a urinary leak occurred increased by a mean of 297 ml (P < 0.05). The maximum hyperreflexic detrusor contraction pressure was reduced by a mean of 24 cm water (P < 0.05). No significant reduction in end fill pressure or compliance was observed though the increase in compliance approached significance. No side effects were observed and no differences were observed in pupillary reactions, blood pressure or pulse after the instillation of atropine.
Ukimura O . Effects of intravesically administered anticholinergics, beta-adrenergic stimulant and alpha-adrenergic blocker on bladder function in unanaesthetised rats. Tohoku J Exp Med 1993; 170: 251–260.
Kato K et al. In vitro intravesical instillation of anticholinergic, antispasmodic and calcium blocking agents to decrease bladder contractility. Urol Int 1991; 47 (Suppl 1): 36–38.
Kato K et al. In vitro intravesical instillation of anticholinergic, antispasmodic and calcium blocking agents (rabbit whole bladder model). J Urol 1989; 141: 1471–1475.
Brendler C B, Radebaugh L C, Mohler J L . Topical oxybutynin chloride for relaxation of dysfunctional bladders. J Urol 1989; 141: 1350–1352.
Connor J P et al. Early cystometrograms can predict the response to intravesical instillation of oxybutynin chloride in myelomeningocoele patients. J Urol 1994; 151: 1045–1047.
Weese D L, Roskamp D A, Leach G E, Zimmern P E . Intravesical oxybutynin chloride: experience with 42 patients. Urology 1993; 41: 527–530.
Greenfield S P, Fera M . The use of intravesical oxybutynin chloride in children with neurogenic bladder. J Urol 1991; 146 (Pt 2): 532–534.
Madersbacher H, Jilg G . Control of detrusor hyperreflexia by the intravesical instillation of oxybutynin hydrochloride. Paraplegia 1991; 29: 84–90.
Innes R I, Nickerson M . Atropine scopolamine and related antimuscarinic drugs. In: Goodman SL, Gillman A (eds). Pharmacological Basis of Therapeutics (5th edn). New York: Macmillan, 1975: 514–532.
Hinderline P H, Gundert-Remy U, Schmidlin O . Integrated pharmacokinetics and pharmacodynamics of atropine in healthy humans. Pharmacokinetics J Pharm Sci 1985; 74: 703–710.
International Continence Society. The standardisation of terminology of lower urinary tract function. Scand J Urol Nephrol 1988; Suppl 114.
About this article
Cite this article
Glickman, S., Tsokkos, N. & Shah, P. Intravesical atropine and suppression of detrusor hypercontractility in the neuropathic bladder. A preliminary study. Spinal Cord 33, 36–39 (1995) doi:10.1038/sc.1995.9
- neuropathic bladder
- anticholinergic drugs
Pediatric Drugs (2017)
Female Pelvic Medicine & Reconstructive Surgery (2014)
Acta Endoscopica (2009)
Intravesical Atropine Compared to Oral Oxybutynin for Neurogenic Detrusor Overactivity: A Double-Blind, Randomized Crossover Trial
Journal of Urology (2007)