The Long-Term, Real-World Effects of Oxybutynin on Pressure Reservoir Function in the Neurogenic Bladder after Spinal Cord Injury: A Retrospective Cohort Study

• Published in: Journal of clinical medicine 2024-08, Vol.13 (15), p.4514
• Main Authors: Boonjaraspinyo, Sirintip, Saengsuwan, Jittima, Sirasaporn, Patpiya, Thinkhamrop, Bandit
• Format: Article
• Language: English
• Subjects: Anticholinergics; Bladder; Cohort analysis; Combination therapy; Diagnosis; Dosage and administration; Drug dosages; Drug therapy; Drug therapy, Combination; Oxybutynin; Patient outcomes; Spinal cord injuries; Trospium; Urogenital system
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13154514

: Data on the long-term effects of oxybutynin in patients with neurogenic bladder (NGB) due to spinal cord injury (SCI) are limited. This study aimed to evaluate the long-term effects of oxybutynin and the combination of oxybutynin with trospium in these patients, under real-world medical conditions. : A total of 107 patients with NGB due to SCI were included. The mean treatment duration was 2.8 years ± 0.8 years. The patients were categorized into three groups: (1) low-dose oxybutynin (5-15 mg/day), (2) high-dose oxybutynin (20-40 mg/day), and (3) oxybutynin combined with trospium. The main outcomes were maximal detrusor pressure (MDP) and cystometric bladder capacity (CBC). Both were assessed at baseline and at three subsequent follow-up visits. Generalized estimation equation models were used to estimate the overall mean reduction in MDP and CBC for each group. : The overall adjusted mean reduction from baseline of MDP in groups 1, 2, and 3 were 2.5 (95% CI: -5.4 to 10.4; = 0.540), 16.9 (95% CI: 4.4 to 29.4; = 0.008), and 21.9 (95% CI: 4.1 to 39.8; = 0.016) cmH O, respectively. For the CBC, the mean reduction was not significant in any group at any visit, nor were the overall mean reductions. : These findings suggest that high-dose oxybutynin and oxybutynin-trospium combination achieve a significant long-term reduction in MDP in patients with NGB after SCI. The effects were sustained across all three follow-up periods.