Pediatric urologyImproved efficacy of extended release oxybutynin in children with persistent daytime urinary incontinence converted from regular oxybutynin
Section snippets
Material and methods
An institutional review board-approved retrospective review of children diagnosed with daytime incontinence seen by one physician (C.S.C.) from 1999 through 2003 was undertaken to search for those taking either form of oxybutynin chloride (Ditropan or Ditropan XL, Ortho-McNeil, Raritan, NJ). Patients taking regular oxybutynin (Ditropan) who switched to the once-a-day, extended-release preparation (Ditropan XL) were included in the study. Patients were excluded from analysis if neurogenic
Results
A total of 27 patients met the inclusion criteria; 12 boys (average age 6.4 ± 0.9 years) and 15 girls (6.3 ± 1.5 years) were evaluated. Patients were followed up for an average of 35.8 ± 18.1 months. On average, the children took oxybutynin for 31.5 ± 18.9 months. The average duration of Ditropan use, preceding the change to Ditropan XL, was 11.6 ± 12.3 months. The average duration of Ditropan XL use was 19.9 ± 13.9 months, which constituted an average of 62.2% ± 23.2% of the entire time that
Comment
The number of studies comparing the use of Ditropan and Ditropan XL is quite limited. Two studies in adults found that immediate-release and extended-release oxybutynin had similar efficacy in reducing urge incontinence, although the extended-release preparation had a lower incidence of dry mouth.10, 11 Another study found that Ditropan XL significantly decreased the frequency of incontinent episodes, yet more than one half of the patients also experienced dry mouth as a side effect.12
The
Conclusions
Forty-eight percent of children with persistent daytime wetting when taking Ditropan became dry or had significant improvement when switched to Ditropan XL. Uroflow parameters also improved significantly after this change. A trial of Ditropan XL seems warranted in children with daytime wetting refractory to regular oxybutynin.
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