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 B Yerkes, Bruce 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 B ; Lindgren, Bruce ; 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.
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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.",
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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 B; Lindgren, Bruce; 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

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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 B

AU - Lindgren, Bruce

AU - Kaplan, William E

AU - Meyer, Theresa

AU - Cheng, Earl Y

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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.

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