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 journalArticlepeer-review

11 Scopus citations

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

Keywords

  • cholinergic antagonists
  • urethral obstruction
  • urinary bladder
  • urodynamics

ASJC Scopus subject areas

  • Urology

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