PDF herunterladen
CC BY 4.0 · European J Pediatr Surg Rep. 2019; 07(01): e90-e92
DOI: 10.1055/s-0039-3399565
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Intravesical Oxybutynin for Urgent Bladder Rescue in a Newborn with Posterior Urethral Valves

Ada Molina Caballero
1   Department of Pediatric Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain
,
Alberto Pérez Martínez
1   Department of Pediatric Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain
,
Concepción Goñi Orayen
2   Division of Neonatology, Complejo Hospitalario de Navarra, Pamplona, Spain
,
Gemma Sierra Colomina
2   Division of Neonatology, Complejo Hospitalario de Navarra, Pamplona, Spain
,
Ana Lavilla Oiz
2   Division of Neonatology, Complejo Hospitalario de Navarra, Pamplona, Spain
,
Yolanda Armendariz Cuevas
2   Division of Neonatology, Complejo Hospitalario de Navarra, Pamplona, Spain
› Institutsangaben
Weitere Informationen

Publikationsverlauf

29. April 2019

20. September 2019

Publikationsdatum:
22. November 2019 (online)

   Lizenzen und Reprints

Abstract

Posterior urethral valves are the most common cause of bladder outlet obstruction in male newborns. Initial catheter drainage alleviates the urethral obstruction before definitive management by valve ablation. Newborns with posterior urethral valves often present with hypercontractile bladders that may inhibit upper tract drainage despite bladder catheterization. Anticholinergic agents are commonly used to treat detrusor hyperactivity, with oxybutynin being the most commonly used. We report the first case of a newborn with posterior urethral valves and ureterovesical junction obstruction caused by detrusor hypertrophy who underwent urgent intravesical instillation of oxybutynin at high doses in an attempt to avoid a diversion procedure.

Keywords

posterior urethral valves - detrusor hypertrophy - oxybutynin - intravesical
 

  • References

  • 1 Thomas J. Etiopathogenesis and management of bladder dysfunction in patients with posterior urethral valves. Indian J Urol 2010; 26 (04) 480-489
    CrossrefPubMedGoogle Scholar
  • 2 Verpoorten C, Buyse GM. The neurogenic bladder: medical treatment. Pediatr Nephrol 2008; 23 (05) 717-725
    CrossrefPubMedGoogle Scholar
  • 3 Guerra LA, Moher D, Sampson M, Barrowman N, Pike J, Leonard M. Intravesical oxybutynin for children with poorly compliant neurogenic bladder: a systematic review. J Urol 2008; 180 (03) 1091-1097
    CrossrefPubMedGoogle Scholar
  • 4 Ferrara P, D'Aleo CM, Tarquini E, Salvatore S, Salvaggio E. Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida. BJU Int 2001; 87 (07) 674-678
    CrossrefPubMedGoogle Scholar
  • 5 Casey JT, Hagerty JA, Maizels M. , et al. Early administration of oxybutynin improves bladder function and clinical outcomes in newborns with posterior urethral valves. J Urol 2012; 188 (4, Suppl): 1516-1520
    CrossrefPubMedGoogle Scholar
  • 6 Luque Mialdea R, Martín-Crespo R, Hernández E. , et al. Use of oral anticholinergic therapy in children under 1 years of age with high risk bladder [in Spanish]. Cir Pediatr 2005; 18 (01) 3-7
    PubMedGoogle Scholar
  • 7 Haferkamp A, Staehler G, Gerner HJ, Dörsam J. Dosage escalation of intravesical oxybutynin in the treatment of neurogenic bladder patients. Spinal Cord 2000; 38 (04) 250-254
    CrossrefPubMedGoogle Scholar
  • 8 Inoue S, Saito M, Honda M, Dimitriadis F, Takenaka A. Intravesical oxybutynin for neurogenic bladder in children. Pediatr Therapeut 2012; 2: 138
    PubMedGoogle Scholar
  • 9 Brendler CB, Radebaugh LC, Mohler JL. Topical oxybutynin chloride for relaxation of dysfunctional bladders. J Urol 1989; 141 (06) 1350-1352
    CrossrefPubMedGoogle Scholar
  • 10 Orgen S, Deliktas H, Sahin H, Gedik A, Nergis Y. Histopathologic and urodynamic effects of the anticholinergic drugs oxybutynin, tolterodine, and trospium on the bladder. Low Urin Tract Symptoms 2017; 9 (01) 52-56
    PubMedGoogle Scholar
  • 11 Honda M, Kimura Y, Tsounapi P, Hikita K, Saito M, Takenaka A. Long-term efficacy, safety, and tolerability of modified intravesical oxybutynin chloride for neurogenic bladder in children. J Clin Med Res 2019; 11 (04) 256-260
    CrossrefPubMedGoogle Scholar
  • 12 Humblet M, Verpoorten C, Christiaens MH. , et al. Long-term outcome of intravesical oxybutynin in children with detrusor-sphincter dyssynergia: with special reference to age-dependent parameters. Neurourol Urodyn 2015; 34 (04) 336-342
    CrossrefPubMedGoogle Scholar
  • 13 Di Stasi SM, Giannantoni A, Navarra P. , et al. Intravesical oxybutynin: mode of action assessed by passive diffusion and electromotive administration with pharmacokinetics of oxybutynin and N-desethyl oxybutynin. J Urol 2001; 166 (06) 2232-2236
    CrossrefPubMedGoogle Scholar