Intravesical oxybutynin for treating incontinence resulting from an overactive detrusor

Lose, Gunnar; Nørgaard, Jens Peter

doi:10.1046/j.1464-410x.2001.02227.x

Cited by 38 publications

(27 citation statements)

References 52 publications

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“…Chez l'adulte, la tolérance de l'oxybutynine intravési-cale apparaît satisfaisante y compris à forte dose et chez des patients ayant présenté une intolérance à l'oxybutynine orale [3][4][5][6][7][8][9][10]17]. Aux doses habituelles de 0,3 mg/kg/j, le taux d'effets systémiques est inférieur à 10 % et a été considéré superposable à celui du placebo intravésical [16].…”

Section: Les Anticholinergiquesunclassified

“…La meilleure tolérance de la voie intravésicale reposerait davantage sur une réduction de l'effet de premier passage hépatique et une moindre transformation en N-déséthyloxybutynine menant à un ratio systémique drogue/métabolite plus favorable que celui de la voie orale [16][17][18].…”

Section: Les Anticholinergiquesunclassified

“…Les solutions sont fabriquées de manière artisanale à partir de comprimés d'oxybutynine à libération immédiate, pilés et dilués en solution saline, dont la solubilité et la stabilité sont imparfaites et l'acidité mal contrôlée [17]. Les dilutions les plus utilisées sont d'1 cp à 5 mg dans 30 ml de solution saline chez l'adulte et d'1/4 de cp à 5 mg dans 5 ml de solution saline chez l'enfant avec adaptation secondaire de la posologie en fonction de la réponse thérapeu-tique chez ces derniers.…”

Section: Les Anticholinergiquesunclassified

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Intérêt des thérapies intravésicales en neuro-urologie

Sèze

Delleci

Ruffion³

2009

Acta Endosc

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Intravesical instillation therapy is an easy way to provide high concentrations of pharmacological agents to bladder tissue without causing significant systemic side effects. Urethral catheterization is frequently used for bladder management and follow-up in neurological patients, making such treatment easy to administer in this population. Several agents have been suggested, acting on either the afferent or efferent arm of the micturition reflex, for the treatment of hyperactive or underactive detrusor in patients who do not respond to first-line oral therapies. Despite the established interest of some agents, their use is limited by the lack of commercially available solutions and/or the short duration of the therapeutic effect, resulting in under-use of this promising approach.

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Section: Les Anticholinergiquesunclassified

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Intérêt des thérapies intravésicales en neuro-urologie

Sèze

Delleci

Ruffion³

2009

Acta Endosc

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“…Oxybutynin has been demonstrated to increase bladder capacity and produce clinical improvement with few side eects when given intravesically (see recent review by Lose and Nùrgaard 2001). Bene®cial eects have been reported both in hyperre¯exia and in other types of bladder overactivity, in both children and adults (e.g.…”

Section: Intravesical Oxybutyninmentioning

confidence: 99%

“…Brendler et al 1989;Buyse et al 1995;Enzelsberger et al 1995;Kaplinsky et al 1996;Madersbacher and Jilg 1991;Madersbacher and Knoll 1995;Mizunaga et al 1994;O'Flynn and Thomas 1993;Weese et al 1993), although adverse eects may occur (Ferrara et al 2001;Kasabian et al 1994;Palmer et al 1997). The reasons for the improved ecacy/adverse eect ratio has not been established, but has been attributed to a slower absorption rate orally (peak plasma concentration at 3 h vs 1 h) than when the drug is given orally (Lose and Nùrgaard 2001). However, the bladder is exposed to high concentrations when oxybutynin is instilled intravesically, and it cannot be excluded that local eects on both the lamina propria and bladder smooth muscle (calcium antagonistic, local anaesthetic) contribute to the antimuscarinic actions (systemic and local) of the drug.…”

Section: Intravesical Oxybutyninmentioning

confidence: 99%

Oxybutynin and the overactive bladder

Andersson¹,

Chapple

2001

World J Urol

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Oxybutynin is a tertiary amine, which undergoes an extensive first-pass metabolism. It has an active metabolite, N-desethyl oxybutynin, and the effect of oral oxybutynin is to a large extent exerted by this metabolite. Oxybutynin has both an antimuscarinic and a direct muscle relaxant effect, and, in addition, local anesthetic actions. Most probably, oral oxybutynin exerts its effects on the overactive bladder (OAB) by an antimuscarinic action. Several studies have shown that oral oxybutynin is effective in controlling OAB. Admininistred intravesically, it can increase bladder capacity and produce clinical improvement both in patients with hypereflexia and in other types of OAB with few side effects. Adverse effects related to the antimuscarinic activity occur frequently and can necessitate treatment discontinuation in up to 25% of patients, depending on the dosage. A controlled-release preparation has recently been introduced. Oxybutynin has a well-documented efficacy in the treatment of detrusor overactivity, and is a drug of first choice in patients with this disorder.

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Pilot study on the effects of intravesical oxybutynin hydrochloride instillations on the validity of doping control urine samples

Walpurgis

Scheiff²,

Welz³

et al. 2019

Drug Testing and Analysis

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According to class M2.1 of the World Anti‐Doping Agency (WADA) Prohibited List, the manipulation of doping control urine samples to alter their integrity and validity is prohibited both in‐ and out‐of‐competition. However, some paraplegic athletes with an overactive bladder need to be regularly treated with anti‐cholinergic and anti‐spasmodic drugs such as oxybutynin, which are often administered intravesically to reduce the substantial side effects observed after oral application. So far, it remains unclear whether such bladder instillations have a negative impact on analytical procedures and thus represent an anti‐doping rule violation. Within this pilot study, urine samples were collected from five paraplegic athletes before and after an intravesical oxybutynin hydrochloride instillation. The samples were routinely tested for the presence of performance‐enhancing drugs and afterwards fortified with 25 model compounds representing different classes of doping agents (anabolic agents, cannabinoids, diuretics, glucocorticoids, hormone and metabolic modulators, and stimulants) at low and medium concentrations. Additionally, the pH value and specific gravity were measured and the presence of oxybutynin was qualitatively determined by gas chromatography−mass spectrometry (GC–MS). In initial testing procedures, all samples were tested negative. Oxybutynin was present in most of the samples but found to have no significant effect on the detectability of the 25 model compounds subsequently added to each urine specimen. Therefore, it can be concluded that intravesical instillations with oxybutynin hydrochloride do not alter the integrity and validity of doping control urine samples.

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Intravesical oxybutynin for treating incontinence resulting from an overactive detrusor

Cited by 38 publications

References 52 publications

Intérêt des thérapies intravésicales en neuro-urologie

Intérêt des thérapies intravésicales en neuro-urologie

Oxybutynin and the overactive bladder

Pilot study on the effects of intravesical oxybutynin hydrochloride instillations on the validity of doping control urine samples

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