The Urodynamic and Subjective Results of Treatment of Detrusor Instability with Oxybutynin Chloride

Moisey, C. U.; Stephenson, T. P.; Brendler, Charles B.

doi:10.1111/j.1464-410x.1980.tb03093.x

Cited by 180 publications

(58 citation statements)

References 11 publications

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“…1,3,4 Despite the volumes of knowledge gained in this field, however, contemporary clinical practice is limited to crude measures designed to minimize bladder distension and intravesical pressure, with clean intermittent catheterization (CIC) and anti-muscarinic medication. 5 The morbidity of contemporary treatment is significant and efficacy moderate, at best. The most significant recent clinical progress has been the realization that earlier and more aggressive application of CIC and medication results in improved outcomes.…”

Section: Introductionmentioning

confidence: 99%

Benefits of mesenchymal stem cells after partial bladder outlet obstruction

Al-Saikan

Ding

Tredget

et al. 2016

CUAJ

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Introduction: Partial bladder outlet obstruction (pBOO) results in significant morbidity and mortality in the pediatric and adult populations. Mesenchymal stem cells (MSC) have been widely studied in many organ systems for the treatment and prevention of fibrotic and inflammatory conditions. Therefore, we hypothesize that systemic administration of MSC will demonstrate short-term biochemical, histological, and urodynamic benefits in an animal model for pBOO. Methods: After University ethics approval, 5 x 106 green fluorescent protein GFP-labeled MSC were intravenously injected concurrently with pBOO in adult Sprague-Dawley rats. Five groups (n=3/ group) were analyzed: a) unobstructed controls; b) pBOO for seven days with intravenous MSC (7d+MSC); c) pBOO for seven days without intravenous MSC (7d-MSC); d) pBOO for 14 days with intravenous MSC (14d+MSC), e) pBOO for 14 days without MSC (14d-MSC). Urodynamics were performed at the end of the experimental period and bladders were weighed. Immunohistochemistry was performed for GFP detection and reverse transcription polymerase chain reaction (RT-PCR) to detect mRNA of: TGF-B, HIF-1a, RhoA, GRP-78, lumican, and decorin. Results: All animals remained healthy. GFP was detected in all treatment groups. MSC treatment resulted in a significant decrease in bladder capacity (0.91 cc vs. 2.15 cc, p=0.04). Treatment also resulted in significant decreases in mRNA levels of: TGF-B, HIF-1a, Rho-A, and GRP-78. Conclusions: Systemic treatment with MSC was well tolerated and resulted in MSC accumulation after pBOO. Despite our low numbers, we were able to successfully demonstrate short-term urodynamic improvements and widespread, significant decreases in inflammatory mediators. We believe that this decreased inflammatory cascade will help prevent long-term detrusor deterioration.

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Section: Introductionmentioning

confidence: 99%

Benefits of mesenchymal stem cells after partial bladder outlet obstruction

Al-Saikan

Ding

Tredget

et al. 2016

CUAJ

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“…Its usefulness is limited by its side effects: xerostomia and constipation. 6 In case of failure of the medical management, surgical intervention with bladder augmentation is the alternative treatment to restore upper urinary tracts.…”

Section: Introductionmentioning

confidence: 99%

Intravesical oxybutynin for spinal cord injury patients

Szollar

Lee

1996

Spinal Cord

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The treatment of choice for the failure to restore neurogenic bladder dysfunction, managed with clean intermittent catheterization program with incontinence, is anticholinergic medication. The goal is to increase bladder capacity, and decrease intravesical pressure in order to maintain continence between catheterizations. The most commonly used anti cholinergic medication in the United States is Oxybutynin. Previous clinical studies have shown that 61 % of the patients on oral Oxybutynin report adverse systemic side effects and are noncompliant in taking it. In 48% of the yatients, possibly due to their noncompliance, oral Oxybutynin Hydrochloride is ineffective. l • In this study, 13 spinal cord injured patients with a failure to restore bladder dysfunction were treated with intravesical Oxybutynin. Nine patients improved on the regimen while one patient underwent surgical bladder augmentation. Postoperatively, this patient continued to be incontinent between catheterizations. Reinstitution of intravesical Oxybutynin stabilized the patient's bladder with clean intermittent catheterization without further intervention.After 3 months post instillation in the urodynamic studies, the mean bladder capacity increased, the mean volume at first contraction increased and the leak point pressure decreased. The decrease in leak point pressure was statistically significant. Leak point pressure is one of the most important parameters we monitor to preserve upper urinary tract function. We recommend the trial of intravesical Oxybutynin for patients who fit the criteria of the protocol prior to surgical bladder augmentation.

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“…Three articles [19][20][21] not specifying adverse events, one article [22] not differentiating adverse events between antimuscarinic and placebo, six articles [23][24][25][26][27][28] not discriminating adverse events between different fixed dosages, and three articles [29][30][31] only comparing different releases within the same antimuscarinic and dosage were excluded. Thus, we finally included 69 trials including one report [66] with two different age strata ( Table 2, Data S2).…”

Section: Resultsmentioning

confidence: 99%

772 Adverse Event Assessment of Antimuscarinics for Treating Overactive Bladder: A Network Meta-Analytic Approach

Kessler¹,

Bachmann²,

Minder³

et al. 2010

European Urology Supplements

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Background: Overactive bladder (OAB) affects the lives of millions of people worldwide and antimuscarinics are the pharmacological treatment of choice. Meta-analyses of all currently used antimuscarinics for treating OAB found similar efficacy, making the choice dependent on their adverse event profiles. However, conventional meta-analyses often fail to quantify and compare adverse events across different drugs, dosages, formulations, and routes of administration. In addition, the assessment of the broad variety of adverse events is dissatisfying. Our aim was to compare adverse events of antimuscarinics using a network meta-analytic approach that overcomes shortcomings of conventional analyses.

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The Urodynamic and Subjective Results of Treatment of Detrusor Instability with Oxybutynin Chloride

Abstract: The results of a double-blind controlled trial using oxybutynin chloride in 30 patients are described. Twenty-three patients completed the study; 17 of these had symptomatic improvement and 9 patients had urodynamic improvement. Seventeen patients had significant side effects.

Cited by 180 publications

References 11 publications

Benefits of mesenchymal stem cells after partial bladder outlet obstruction

Benefits of mesenchymal stem cells after partial bladder outlet obstruction

Intravesical oxybutynin for spinal cord injury patients

772 Adverse Event Assessment of Antimuscarinics for Treating Overactive Bladder: A Network Meta-Analytic Approach

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