The effectiveness of intravesical oxybutynin in the management of overactive bladder: a clinical study

Overactive bladder (OAB) syndrome is a chronic, debilitating disorder with physical, psychological, and social repercussions that considerably reduces the quality of life for 12-17% of the population. Despite the emergence of novel antimuscarinic medicines, many OAB syndrome patients are unable to tolerate or respond to oral treatment. Oxybutynin hydrochloride (OH) is one of the most essential medications available. The purpose of this article is to investigate the efficacy of intravesical OH in treating patients with OAB who are unresponsive to oral medication or who experience intolerable systemic side effects of anticholinergic drugs. OH was administered intravesically to 48 patients with neurogenic bladder and incontinence more than 8 times a day. Treatment consisted of dissolving 5 mg OH tablets in sterile saline, 40 mL, once a week. The duration of intravesical treatment with OH was applied once a week for 4 weeks. The rate of improvement was remarkable, and the best response was 70% in all 48 patients. Cystometrography was performed and revealed that cystocapacity before and after the initial modified intravesical oxybutynin was 123.41±24.83 and 308.08±30.68, respectively. One patient complained of slight pain in the lower abdomen, but this effect gradually subsided as treatment continued. The patient continued the entire treatment with four doses. These encouraging results indicate that intravesical instillation of OH is an attractive, effective, and safe alternative therapy in patients with neurogenic bladder who either do not respond or have intolerable side effects from oral medications.