Untoward effects and inconvenience are the most common reasons for discontinuing intravesical oxybutynin chloride therapy for neurogenic bladder dysfunction. Children who previously had side effects from oral oxybutynin chloride are more likely to have them during intravesical therapy.
CIC was an easy technique for most sensate children to learn in 1 visit and master in a short time. Overall comfort with the technique was excellent and few problems were encountered. Their HRQOL was comparable to that of normal children.
Untoward effects and inconvenience are the most common reasons for discontinuing intravesical oxybutynin chloride therapy for neurogenic bladder dysfunction. Children who previously had side effects from oral oxybutynin chloride are more likely to have them during intravesical therapy.
The group of children who followed physician advised treatment for primary nocturnal enuresis showed significantly earlier remission of primary nocturnal enuresis than children who followed the parent choice treatment (25th percentile 2 vs 10 weeks).
Selective sacral rhizotomy was introduced for the management of high pressure neurogenic bladders commonly encountered in myelodysplastic patients. In 1992, 2 of us (I.F. and W.K.) first reported results with selective sacral rhizotomy and cord untethering in 8 spina bifida patients. We report long-term followup of our original 8 patients and 3 additional patients. This followup demonstrates remarkable success in maintaining bladder volume and low pressures after rhizotomy and cord untethering. Uninhibited contractions resolved in all patients postoperatively. A more favorable response occurred in the patients younger than 9 years, supporting early intervention with selective sacral rhizotomy.
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