The Effectiveness of Intravesical Oxybutynin, Propantheline, and Capsaicin in the Management of Neuropathic Bladder following Spinal Cord Injury

TheScientificWorldJOURNAL, 2007 · DOI: 10.1100/tsw.2007.271 · Published: October 22, 2007

Simple Explanation

Neuropathic bladder after spinal cord injury can lead to urinary incontinence and kidney problems. This study explores using medications directly in the bladder to manage this issue. The study compares oxybutynin, propantheline, and capsaicin, delivered directly into the bladder, to see which is most effective in reducing bladder overactivity. The goal is to find a treatment that reduces the systemic side effects often caused by oral medications, while still improving bladder control.

Study Duration
Not specified
Participants
18 SCI patients with neuropathic bladders
Evidence Level
Not specified

Key Findings

  • 1
    Intravesical capsaicin significantly improved reflex volume, cystometric capacity, leak volume, and leak frequency in treating neurogenic detrusor overactivity.
  • 2
    Propantheline showed more improvement than oxybutynin for reflex volume, detrusor leak point pressure, clean intermittent catheterization volume, and leak volume.
  • 3
    Significant differences were found in the therapeutic response between oxybutynin, propantheline, and capsaicin for leak volume and leak frequency at 2 weeks.

Research Summary

The study compared intravesical oxybutynin, propantheline, and capsaicin for treating neurogenic detrusor overactivity (NDO) following spinal cord injury (SCI). Capsaicin showed statistically significant improvements in several urodynamic parameters, particularly a decrease in leak volume and frequency after two weeks. Propantheline demonstrated more improvement than oxybutynin in several parameters, suggesting its potential as an effective intravesical agent.

Practical Implications

Alternative Treatment Option

Intravesical agents can serve as effective adjuvants in managing incontinence due to overactive neuropathic bladders following SCI, offering an alternative to systemic medications.

Personalized Treatment

The varying responses to oxybutynin, propantheline, and capsaicin suggest the need for personalized treatment approaches based on individual patient profiles.

Further Research

Further research is warranted to optimize the dosage and administration protocols for intravesical capsaicin to maximize its therapeutic benefits.

Study Limitations

  • 1
    Small sample size
  • 2
    Lack of blinding for capsaicin instillation
  • 3
    Short follow-up period

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