Intravesical instillation of atropine in treatment of detrusor overactivity in children

UNLABELLED: We present our own experiences with intravesical Atropine instillation in patients with voiding dysfunction. We used concentration of 10(-6) Atropine in 14 patients with detrusor overactivity. In 12 patients neurogenic voiding dysfunction was caused by a meningomyelocoele. In 2 dysfunction was non-neurogenic. Patients were selected on the base of urodynamic investigation in which low bladder cystometric capacity was caused by detrusor overactivity and poor bladder compliance. This type of therapy was started in patients who had not responded to oral oxybutynin therapy, had major side-effects, or oral therapy had not been possible. All were on clean intermittent catheterisation. The effects on the functional parameters were estimated in urodynamic investigations. With the aim of estimating systemic side-effects blood pressure and heart rate was monitored during Atropine infusion. RESULTS: 6 patients responded to intravesical instillation of Atropine. The increase in bladder cystometric capacity was caused by the decrease in bladder overactivity. No effect on bladder wall compliance was noted. No systemic side-effects were observed. CONCLUSIONS: 1. Intravesical Atropine instillation was useful method of treatment in some patients with detrusor overactivity. 2. No systemic side effects were noted. 3. Because of limited effectiveness and low cost, this method should be considered as an alternative way of decreasing bladder overactivity.