INTRAVESICAL OXYBUTYNIN CHLORIDE AND CLEAN INTERMITTENT CATHETERIZATION IN PATIENTS WITH NEUROGENIC VESICAL DYSFUNCTION AND DECREASED BLADDER CAPACITY

Oral administration of oxybutynin chloride is effective in increasing bladder capacity in patients with neurogenic bladder dysfunction who are practising clean intermittent catheterisation, but it is often associated with systemic side effects. The eff ect of intravesical instillation of oxybutynin chloride was studied in 14 patients who were practising clean intermittent catheterisation and in whom the maximum cystometric capacity was < 250 ml and/or vesical compliance < 5. A 5-mg tablet of oxybutynin chloride was crushed and suspended in 10 ml of boiled and cooled water and instilled into the bladder after emptying it completely; this was carried out thrice daily either by the patient or by his carer. During follow-up (6-12 months) no local or systemic side effects were observed and patient compliance was excellent in 12 patients, who showed an increase in maximum cystometric capacity and vesical compliance. One patient could not retain the drug intravesically because of reflex detrusor contraction and he was excluded from the study. One patient was lost to follow-up. The results suggest that the intravesical instillation of oxybutynin chloride is safe and effective in the treatment of selected patients with neurogenic bladder dysfunction whose bladder capacity is small and who are practising clean intermittent catheterisation.