Early administration of oxybutynin improves bladder function and clinical outcomes in newborns with posterior urethral valves.

Autor:	Casey JT; Division of Urology, Children's Memorial Hospital and Department of Urology, The Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA. jtcasey@fsm.northwestern.edu, Hagerty JA, Maizels M, Chaviano AH, Yerkes E, Lindgren BW, Kaplan WE, Meyer T, Cheng EY
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2012 Oct; Vol. 188 (4 Suppl), pp. 1516-20. Date of Electronic Publication: 2012 Aug 19.
DOI:	10.1016/j.juro.2012.03.068
Abstrakt:	Purpose: Abnormal bladder function following posterior urethral valve ablation can lead to deleterious effects on renal function and urinary continence. We performed a pilot study to determine if bladder dysfunction could be ameliorated by the early administration of oxybutynin. Materials and Methods: We enrolled infants who underwent primary posterior urethral valve ablation by the age of 12 months. On initial urodynamics patients demonstrating high voiding pressures (greater than 60 cm H(2)O) and/or small bladder capacity (less than 70% expected) were started on oxybutynin. Urodynamics and ultrasound were performed every 6 months until completion of toilet training, at which time oxybutynin was discontinued. Results: Oxybutynin was started in 18 patients at a mean age of 3.4 months and was continued for a mean of 2.2 years. Urodynamics revealed that initial high voiding pressures improved from a mean of 148.5 to 49.9 cm H(2)O in 15 of 17 patients. All 8 patients with initially poor bladder compliance demonstrated improvement on oxybutynin. All 7 patients with initially low bladder capacity (mean 47.7% expected bladder capacity) demonstrated improvement while on oxybutynin (mean 216% expected bladder capacity). Conclusions: This pilot study demonstrates that early use of anticholinergic therapy in infants with high voiding pressures and/or small bladder capacity after primary posterior urethral valve ablation has beneficial effects on bladder function. (Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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