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Compensatory hyperhidrosis: results of pharmacologic treatment with oxybutynin.

AbstractBACKGROUND:
Hyperhidrosis may affect nearly 3% of the population, and thoracic/lumbar sympathectomy has been highly effective. Compensatory hyperhidrosis is a risk associated with surgical procedures, and its treatment is both complex and not well defined. Treatment of primary hyperhidrosis with oxybutynin has yielded positive results; however, its use in compensatory hyperhidrosis (CH) has not been described.
METHODS:
Twenty-one patients (11 female patients) received oxybutynin for severe CH at a median of 5 years after sympathectomy. Patients were evaluated to determine quality of life before starting oxybutynin and 6 weeks afterward; they assigned grades to determine improvement after 6 weeks and at their last consult visit for each site at which they complained of symptoms.
RESULTS:
Six and 15 patients underwent operation for axillary hyperhidrosis and palmar hyperhidrosis, respectively. Median follow-up time with oxybutynin was 377 days (49-1,831 days). Most common CH sites were the back (n=8) and abdomen (n=5). After 6 weeks, the quality of life improved in 71.4% of patients. Five patients stopped treatment: 2 because of unbearable dry mouth, 1 because of absence of pharmacologic response, 1 because of excessive somnolence, and 1 because of probable tachyphylaxis. At the last visit, 71.4% of patients presented with moderate to major improvement at the main sites at which sweating was noted.
CONCLUSIONS:
More than 70% of patients presented with improved overall quality of life and improvement at the most prominent site of compensatory sweating. Long-term treatment was ineffective in less than 25% of patients, primarily because of the side effects of dry mouth and somnolence. Oxybutynin appears to be effective in treating bothersome CH.
AuthorsMarcelo Passos Teivelis, Nelson Wolosker, Mariana Krutman, José Ribas Milanez de Campos, Paulo Kauffman, Pedro Puech-Leão
JournalThe Annals of thoracic surgery (Ann Thorac Surg) Vol. 98 Issue 5 Pg. 1797-802 (Nov 2014) ISSN: 1552-6259 [Electronic] Netherlands
PMID25173719 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
CopyrightCopyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Mandelic Acids
  • Parasympatholytics
  • oxybutynin
Topics
  • Adolescent
  • Adult
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperhidrosis (drug therapy, physiopathology)
  • Male
  • Mandelic Acids (administration & dosage)
  • Middle Aged
  • Parasympatholytics (administration & dosage)
  • Patient Satisfaction
  • Quality of Life
  • Retrospective Studies
  • Sweating (drug effects)
  • Time Factors
  • Treatment Outcome
  • Young Adult

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