UroToday - Anticholinergic therapy remains the first line treatment for detrusor instability (DI), which is typically characterized by urinary urge incontinence. The aim of this study by Kilic et al was to assess the effectiveness and tolerability of tolterodine and oxybutynin in children with DI. They had a total of 60 children with DI enrolled prospectively and followed for 6 months. Thirty (14 male, 16 female, mean age 7.97 2.71 years) were in the tolterodine group and 30 (12 male, 18 female, mean age 7.33 2.23 years) in the oxybutynin group. All of the patients in the study population had a history of dysfunctional voiding. Urodynamic investigations were conducted in all of the patients before and after anticholinergic treatment. Episodes of urge urinary incontinence and side effects were also evaluated.

The group found that there were similar improvements in urge incontinence episodes in both groups. Improvements in the urodynamic parameters were also the same in the two groups. Side effects were significantly lower in the tolterodine group (13 events in 13 patients) compared to the oxybutynin group (27 events in 20 patients; P = 0.027).

The group concluded that tolterodine and oxybutynin reduced urge urinary incontinence in a similar manner in children with DI. They found that side effects were more common with oxybutynin. They postulate that the treatment with tolterodine in children with DI shows significantly better tolerability and this may improve the children's compliance during long-term treatment.

By Pasquale Casale, MD

Reference:
Int J Urol. 2006 Feb;13(2):105-8
ncbi.nlm.nih/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16563131&query_hl=2&itool=pubmed_docsum
Kilic N, Balkan E, Akgoz S, Sen N, Dogruyol H

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