Urodynamic effects of propiverine in children and adolescents with neurogenic bladder: Results of a prospective long-term study

作者:Schulte Baukloh Heinrich*; Muertz Gerd; Heine Gert; Austin Paul; Miller Kurt; Michael Theodor; Strugala Gerhard; Knispel Helmut H
来源:Journal of Pediatric Urology, 2012, 8(4): 386-392.
DOI:10.1016/j.jpurol.2011.07.014

摘要

Objective: To evaluate prospectively the efficacy and tolerability of propiverine for long-term treatment of neurogenic detrusor overactivity (NDO) in children. Materials and methods: 17 children and adolescents with NDO (10 female, 7 male; average age at last consultation 13.0 years) were evaluated during long-term treatment with propiverine (0.8 mg/kg body weight/day). Outcome measurements included urodynamic parameters, continence, hydronephrosis and tolerability of propiverine. Results: Average follow-up was 3.6 years (range 2.0-5.9). The average maximum detrusor pressure was 33.2 + 4.8 cmH(2)O and bladder compliance was 20.0 + 5.4 ml/cmH(2)O at the last follow-up visit. Maximum cystometric bladder capacity (MCBC) within the normal range was attained in 11 patients; it was still reduced (average of 61% of expected MCBC) in the remaining 6. Incontinence occurred on average once per day. Hydronephrosis was classified for each renal unit separately: grade 0 was measured in 26 and 22 cases, grade 1 or 2 in 6 and 8 cases, grade 3 or 4 in 2 and 4 cases pre and post treatment, respectively. In 6/17 patients adjuvant intravesical oxybutynin was applied, in 4 out of these 6 patients more invasive procedures, such as untethering, augmentation cystoplasty or botulinum toxin injections, were necessitated. Propiverine monotherapy was well tolerated in 11/17 patients. No serious adverse events were encountered during the study period. Conclusion: Long-termefficacy and tolerability of propiverine for NDO in children and adolescents is promising: clinically relevant improvements in key urodynamic outcomes were paralleled by improvements in incontinence score.

  • 出版日期2012-8