Urodynamic Effects of Oral Oxybutynin Chloride in Children With Myelomeningocele and Detrusor Hyperreflexia

Goessl, Carsten; Knispel, Helmut H.; Fiedler, U; Härle, B; Steffen-Wilke, Kristina; Miller, Kurt

doi:10.1016/s0090-4295(97)00489-5

Cited by 49 publications

(19 citation statements)

References 23 publications

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“…In the present study, FDV, cystometric capacity and bladder compliance were improved significantly with mirabegron, and these results were comparable with those of previous reports on anticholinergic agents . In contrast, P det at cystometric capacity, which reflected the bladder tone at the end‐filling bladder capacity, did not change significantly.…”

Section: Discussionsupporting

confidence: 91%

“…reported that the combination of CIC with anticholinergic medication is beneficial for patients with spinal cord injury who show storage and voiding failure . Although several reports have proved that these drugs increase bladder capacity, decrease P det during the filling phase and improve bladder compliance, the persistence rate is low because of the associated adverse events, such as dry mouth and constipation …”

Section: Discussionmentioning

confidence: 99%

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Video‐urodynamic effects of mirabegron, a β₃‐adrenoceptor agonist, in patients with low‐compliance bladder

et al. 2015

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Abbreviations & Acronyms AA = anticholinergic agents BC = bladder compliance BoNT-A = botulinum toxin A CC = cystometric capacity CE = cleansing enema CIC = clean intermittent catheterization DO = detrusor overactivity Dx/HA = dextranomer hyaluronic acid copolymer injection for vesicoureteral reflux FDV = first desire to void JUH = Jikei University Hospital LUTD = lower urinary tract dysfunction OAB = overactive bladder P abd = abdominal pressure (cmH 2 O) P det = detrusor pressure P ves = intravesical pressure (cmH 2 O) UTH = The University of Tokyo Hospital UTI = urinary tract infection Vol. = infusion volume (mL) V-UDS = video-urodynamic study VUR = vesicoureteral reflux Objectives: To investigate video-urodynamic effects of mirabegron, a b 3 -adrenoceptor agonist, on low-compliance bladder. Methods: We retrospectively reviewed nine patients (three men, six women, age 17-68 years) who had been diagnosed with lower urinary tract dysfunction with lowcompliance bladder, and who underwent video-urodynamic study before and during administration of mirabegron 50 mg once daily. Urodynamic parameters were compared before and after treatment. Results: Mirabegron treatment significantly increased first desire to void and cystometric capacity with an average increment of 80 mL (P = 0.027) and 123 mL (P = 0.005), respectively. Bladder compliance also significantly increased (mean value 8.1 mL/cmH 2 O before, 18.2 mL/cmH 2 O after, P = 0.024). In the six patients who had been taking anticholinergic agents at baseline video-urodynamic study and then switched to mirabegron, mean cystometric capacity and bladder compliance were also increased significantly from 208.3 to 346.8 mL (P = 0.015) and from 7.2 to 17.5 mL/cmH 2 O (P = 0.047), respectively. Vesicoureteral reflux grade was improved in three of the four patients who had shown vesicoureteral reflux on cystography before treatment. Conclusions: Mirabegron improves cystometric capacity and bladder compliance, and it lowers vesicoureteral reflux grade in patients with low-compliance bladder. Thus, mirabegron might represent a good alternative drug for low-compliance bladder refractory to anticholinergic treatment.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Video‐urodynamic effects of mirabegron, a β₃‐adrenoceptor agonist, in patients with low‐compliance bladder

et al. 2015

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“…In this sense, self catheterisation need to be adjusted in order to empty the bladder before it reaches its maximum capacity in an attempt to significantly reduce incontinence episodes in between intervals. Bladder capacity may be optimized with the rationale use of anticholinergic agents which may control unhibited detrusor contractions, maintain storage volumes and prevent the development of poor compliance [7,8].…”

Section: Pre Operative Evaluationmentioning

confidence: 99%

Continent Urinary Diversions in Non Oncologic Situations: Alternatives and Complications

Miyaoka¹,

Aguiar²

2012

Urinary Incontinence

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“…6 In children with myelodysplasia, there are two RCTs 7,8 and 11 observational studies. [9][10][11][12][13][14][15][16][17][18][19] Looking at all this evidence, propiverine, trospium, oxybutynin, propantheline and tolterodine have all been shown to produce clinical and some evidence of urodynamic improvement in NDO. Although this evidence is sufficient to conclude that "antimuscarinics are effective in NDO," prescribing more recently introduced antimuscarinics is not evidence-based.…”

Section: Antimuscarinic Therapy For Neurogenic Detrusor Overactivitymentioning

confidence: 99%

Systematic review of therapy for neurogenic detrusor overactivity

Fowler¹

2011

CUAJ

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While many neurologic diseases predispose patients to neurogenic detrusor overactivity (NDO), the only populations that have been systematically studied are adults with multiple sclerosis (MS), adults with spinal cord injury (SCI) and children and young adults with myelodysplasia. First-line pharmacotherapy for NDO is an antimuscarinic drug. However, the evidence base for these agents in this indication is poor. There is some high-quality evidence for the efficacy of detrusor injections of botulinum toxin A in the treatment of NDO, with significant reduction in urgency incontinence episodes, improved urodynamic parameters, and improved quality of life. While few adverse events have been reported with this therapy, there is a need for intermittent self-catheterization in these groups. N eurogenic detrusor overactivity (NDO) can be seen with various neurological diseases. At present, however, the only such populations that have been systematically studied are adults with multiple sclerosis (MS) and spinal cord injury (SCI) and children and young adults with myelodysplasia. There have yet to be any randomized, controlled studies evaluating therapy for NDO in Parkinson's Disease or dementia. This review will, therefore, focus on the available treatment evidence from the above-mentioned conditions. Antimuscarinic therapy for neurogenic detrusor overactivityThe first-line, mainstay treatment of NDO is the antimuscarinic drugs. This practice is not, however, based on a great deal of high quality research. Indeed, the body of evidence for their efficacy based on randomized controlled trials (RCTs) is surprisingly poor. In total, there are only five Grade-A studies in adults.1-5 These studies, which spanned from 1985 to 2007, examined the effect of oral propiverine, oxybutynin, trospium or propantheline or intravesical atropine. The research in MS has also been reviewed in a systematic fashion in a Cochrane review published in 2009. 6 In children with myelodysplasia, there are two RCTs 7,8 and 11 observational studies. 9-19Looking at all this evidence, propiverine, trospium, oxybutynin, propantheline and tolterodine have all been shown to produce clinical and some evidence of urodynamic improvement in NDO. Although this evidence is sufficient to conclude that "antimuscarinics are effective in NDO," prescribing more recently introduced antimuscarinics is not evidence-based. Rather, there is an assumption that their demonstrated efficacy in non-neurogenic DO is "carried over" to the NDO group. Indeed, everyday clinical experience does seem to bear that assumption out and even suggests that antimuscarinics may in fact be more efficacious in NDO than in idiopathic DO and that their benefits are longer lasting. Other oral therapies for neurogenic detrusor overactivity DesmopressinThe evidence for efficacy of desmopressin in MS for treatment of nocturia and daytime frequency is level 1, based on the results of a meta-analysis published in 2005. 20 However, desmopressin does carry the risk of hyponatremia, particularly ...

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Urodynamic Effects of Oral Oxybutynin Chloride in Children With Myelomeningocele and Detrusor Hyperreflexia

Cited by 49 publications

References 23 publications

Video‐urodynamic effects of mirabegron, a β₃‐adrenoceptor agonist, in patients with low‐compliance bladder

Video‐urodynamic effects of mirabegron, a β₃‐adrenoceptor agonist, in patients with low‐compliance bladder

Continent Urinary Diversions in Non Oncologic Situations: Alternatives and Complications

Systematic review of therapy for neurogenic detrusor overactivity

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Urodynamic Effects of Oral Oxybutynin Chloride in Children With Myelomeningocele and Detrusor Hyperreflexia

Cited by 49 publications

References 23 publications

Video‐urodynamic effects of mirabegron, a β3‐adrenoceptor agonist, in patients with low‐compliance bladder

Video‐urodynamic effects of mirabegron, a β3‐adrenoceptor agonist, in patients with low‐compliance bladder

Continent Urinary Diversions in Non Oncologic Situations: Alternatives and Complications

Systematic review of therapy for neurogenic detrusor overactivity

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Product

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Video‐urodynamic effects of mirabegron, a β₃‐adrenoceptor agonist, in patients with low‐compliance bladder

Video‐urodynamic effects of mirabegron, a β₃‐adrenoceptor agonist, in patients with low‐compliance bladder