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

Jessica T. Casey*, Jennifer A. Hagerty, Max Maizels, Antonio H. Chaviano, Elizabeth Yerkes, Bruce W. Lindgren, William E. Kaplan, Theresa Meyer, Earl Y. Cheng

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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 H2O) 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 H2O 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.

Original languageEnglish (US)
Pages (from-to)1516-1520
Number of pages5
JournalJournal of Urology
Volume188
Issue number4 SUPPL.
DOIs
StatePublished - Oct 1 2012

Fingerprint

Urinary Bladder
Newborn Infant
Urodynamics
Pressure
Toilet Training
oxybutynin
Cholinergic Antagonists
Compliance
Kidney

Keywords

  • cholinergic antagonists
  • urethral obstruction
  • urinary bladder
  • urodynamics

ASJC Scopus subject areas

  • Urology

Cite this

Casey, Jessica T. ; Hagerty, Jennifer A. ; Maizels, Max ; Chaviano, Antonio H. ; Yerkes, Elizabeth ; Lindgren, Bruce W. ; Kaplan, William E. ; Meyer, Theresa ; Cheng, Earl Y. / Early administration of oxybutynin improves bladder function and clinical outcomes in newborns with posterior urethral valves. In: Journal of Urology. 2012 ; Vol. 188, No. 4 SUPPL. pp. 1516-1520.
@article{ca2d8205cec24c2eb3621034e2fd9aee,
title = "Early administration of oxybutynin improves bladder function and clinical outcomes in newborns with posterior urethral valves",
abstract = "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 H2O) 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 H2O 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.",
keywords = "cholinergic antagonists, urethral obstruction, urinary bladder, urodynamics",
author = "Casey, {Jessica T.} and Hagerty, {Jennifer A.} and Max Maizels and Chaviano, {Antonio H.} and Elizabeth Yerkes and Lindgren, {Bruce W.} and Kaplan, {William E.} and Theresa Meyer and Cheng, {Earl Y.}",
year = "2012",
month = "10",
day = "1",
doi = "10.1016/j.juro.2012.03.068",
language = "English (US)",
volume = "188",
pages = "1516--1520",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4 SUPPL.",

}

Early administration of oxybutynin improves bladder function and clinical outcomes in newborns with posterior urethral valves. / Casey, Jessica T.; Hagerty, Jennifer A.; Maizels, Max; Chaviano, Antonio H.; Yerkes, Elizabeth; Lindgren, Bruce W.; Kaplan, William E.; Meyer, Theresa; Cheng, Earl Y.

In: Journal of Urology, Vol. 188, No. 4 SUPPL., 01.10.2012, p. 1516-1520.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early administration of oxybutynin improves bladder function and clinical outcomes in newborns with posterior urethral valves

AU - Casey, Jessica T.

AU - Hagerty, Jennifer A.

AU - Maizels, Max

AU - Chaviano, Antonio H.

AU - Yerkes, Elizabeth

AU - Lindgren, Bruce W.

AU - Kaplan, William E.

AU - Meyer, Theresa

AU - Cheng, Earl Y.

PY - 2012/10/1

Y1 - 2012/10/1

N2 - 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 H2O) 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 H2O 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.

AB - 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 H2O) 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 H2O 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.

KW - cholinergic antagonists

KW - urethral obstruction

KW - urinary bladder

KW - urodynamics

UR - http://www.scopus.com/inward/record.url?scp=84866060341&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866060341&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2012.03.068

DO - 10.1016/j.juro.2012.03.068

M3 - Article

C2 - 22910256

AN - SCOPUS:84866060341

VL - 188

SP - 1516

EP - 1520

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4 SUPPL.

ER -