Si-Hong Shen1, Xue Jia2, Liao Peng1, Xiao Zeng1, Hong Shen1, De-Yi Luo3. 1. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China. 2. Department of Postgraduate, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. 3. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China. luodeyi1985@163.com.
Abstract
PURPOSE: To evaluate the effectiveness and safety of intravesical oxybutynin therapy for patients with neurogenic detrusor overactivity. METHODS: A systematic search in PubMed, MEDLINE, EMBASE, ClinicalTrial.gov, and Cochrane Controlled Trials Register was conducted from 1990 to 2021. Nineteen studies were included for analysis, of which 392 patients including both adults and children were treated with intravesical oxybutynin. The analysis was performed by Cochrane RevMan® software, version 5.3. The primary outcomes were maximum bladder capacity (MBC), detrusor pressure at MBC, and bladder compliance. The secondary outcomes were episodes of urinary incontinence and side effects. RESULTS: MBC displayed an increase of 77.8 ml (95% CI 56.9 to 98.7) in kids, 110.8 ml (95% CI 58.95 to 162.7) in adults, respectively. Detrusor pressure at MBC demonstrated an improvement of - 18.8 cm H2O (95% CI - 26.2 to - 11.3) in kids, - 23.2 cm H2O (95% CI - 32.6 to - 13.8) in adults, respectively. The bladder compliance increased 5.8 ml/cm H2O (95% CI 3.4 to 8.1) among kids. The mean percentage of patients "dry or improved" after treatment accounted for 76.9% in adults and 74.6% in kids, respectively. Among all patients, 53 (13.5%) reported side effects, 80 (20.4%) discontinued this treatment, 26 (6.6%) withdrew because of side effects, and 35 (8.9%) quit due to inconvenience. CONCLUSION: Intravesical oxybutynin treatment could be a feasible treatment for both adults and children with neurogenic detrusor overactivity, because of its good effect and less side effects.
PURPOSE: To evaluate the effectiveness and safety of intravesical oxybutynin therapy for patients with neurogenic detrusor overactivity. METHODS: A systematic search in PubMed, MEDLINE, EMBASE, ClinicalTrial.gov, and Cochrane Controlled Trials Register was conducted from 1990 to 2021. Nineteen studies were included for analysis, of which 392 patients including both adults and children were treated with intravesical oxybutynin. The analysis was performed by Cochrane RevMan® software, version 5.3. The primary outcomes were maximum bladder capacity (MBC), detrusor pressure at MBC, and bladder compliance. The secondary outcomes were episodes of urinary incontinence and side effects. RESULTS: MBC displayed an increase of 77.8 ml (95% CI 56.9 to 98.7) in kids, 110.8 ml (95% CI 58.95 to 162.7) in adults, respectively. Detrusor pressure at MBC demonstrated an improvement of - 18.8 cm H2O (95% CI - 26.2 to - 11.3) in kids, - 23.2 cm H2O (95% CI - 32.6 to - 13.8) in adults, respectively. The bladder compliance increased 5.8 ml/cm H2O (95% CI 3.4 to 8.1) among kids. The mean percentage of patients "dry or improved" after treatment accounted for 76.9% in adults and 74.6% in kids, respectively. Among all patients, 53 (13.5%) reported side effects, 80 (20.4%) discontinued this treatment, 26 (6.6%) withdrew because of side effects, and 35 (8.9%) quit due to inconvenience. CONCLUSION: Intravesical oxybutynin treatment could be a feasible treatment for both adults and children with neurogenic detrusor overactivity, because of its good effect and less side effects.
Authors: Jan Groen; Jürgen Pannek; David Castro Diaz; Giulio Del Popolo; Tobias Gross; Rizwan Hamid; Gilles Karsenty; Thomas M Kessler; Marc Schneider; Lisette 't Hoen; Bertil Blok Journal: Eur Urol Date: 2015-08-22 Impact factor: 20.096
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