Abstract | OBJECTIVE: METHODS: From 2000 to 2010, eighteen children with resistant non-neurogenic daytime urinary incontinence were treated with oral ephedrine hydrochloride at our institution. Sixteen were female and two were male. Median age at treatment was 12 years (range 5-15 years). Two children had spina bifida occulta. There were no other co-morbidities. Multiple anticholinergics were prescribed and dose maximized to support a bladder and bowel training programme, without achieving continence in this resistant group of children. Pre-treatment urodynamics were normal in 10, but revealed an open bladder neck in 8 patients. None showed detrusor over-activity. Oral ephedrine hydrochloride was started at 7.5 mg or 15 mg twice daily and titrated up to a maximum of 30 mg four times daily according to response. RESULTS: Median follow-up was 7 years (range 6-8 years). Seventeen children (94%) reported improvement in symptoms and six (33%) achieved complete urinary continence. All patients maintained compliant bladders on post-treatment urodynamics. Seven of the 8 previously open bladder necks were closed. No patients reported any significant side effects. Patients with open bladder necks on pre-treatment urodynamics were more likely to show a full response to ephedrine (odds ratio 15; 95% CI 1.2-185.2). CONCLUSIONS:
|
Authors | Neil Featherstone, Joanna Stanwell, Susan Affleck, Kate Wang, Feilim Murphy, Su-Anna Boddy |
Journal | Journal of pediatric urology
(J Pediatr Urol)
Vol. 9
Issue 6 Pt A
Pg. 915-8
(Dec 2013)
ISSN: 1873-4898 [Electronic] England |
PMID | 23332206
(Publication Type: Clinical Trial, Journal Article)
|
Copyright | Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved. |
Chemical References |
- Adrenergic Agents
- Ephedrine
|
Topics |
- Adolescent
- Adrenergic Agents
(administration & dosage)
- Child
- Child, Preschool
- Diurnal Enuresis
(diagnostic imaging, drug therapy)
- Dose-Response Relationship, Drug
- Ephedrine
(administration & dosage)
- Female
- Follow-Up Studies
- Humans
- Male
- Radiography
- Spinal Dysraphism
(surgery)
- Toilet Training
- Treatment Outcome
- Urinary Bladder
(drug effects)
- Urinary Bladder Neck Obstruction
(surgery)
- Urodynamics
(drug effects)
|