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Intravesical oxybutynin in the pediatric neurogenic bladder

Nature Reviews Urology volume 6, pages 671–674 (2009)Cite this article

Abstract

Pediatric neuropathic bladder dysfunction can cause irreversible renal damage and urinary incontinence. Etiologically, it is usually the consequence of a congenital neural tube defect. The majority of affected children can be successfully managed with the standard medical treatment of clean intermittent catheterization and anticholinergic (typically oxybutynin) medication. A subset of patients experience severe side effects or insufficient suppression of detrusor overactivity on oral oxybutynin. Intravesical instillations offer an effective alternative; this Review considers their indications, administration, safety and efficacy.

Key Points

  • Topical therapy for pediatric neuropathic bladder has been suggested as an alternative to the standard treatment of oral anticholinergics and intermittent catheterization

  • A subset of children who fail to respond adequately to oral anticholinergics might be candidates for intravesical therapy

  • Initial reports of intravesical oxybutynin claim greater urodynamic efficacy and reduced side effects

  • Use of intravesical oxybutynin has proved effective in a small number of studies, but claims regarding superiority over oral administration are hampered by the low level of evidence

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Authors and Affiliations

  1. Division of Urology, Red Cross Children's Hospital, University of Cape Town, South Africa

    John Lazarus

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  1. John Lazarus
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Correspondence to John Lazarus.

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The author declares no competing financial interests.

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Lazarus, J. Intravesical oxybutynin in the pediatric neurogenic bladder. Nat Rev Urol 6, 671–674 (2009). https://doi.org/10.1038/nrurol.2009.214

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