EFFICACY AND SAFETY OF TRANSDERMAL OXYBUTYNIN VERSUS ORAL OXYBUTYNIN IN THE MANAGEMENT OF PEDIATRIC NEUROGENIC BLADDER
Pediatric neurogenic bladder is a complex condition, for which oxybutynin is the gold standard pharmacotherapy. Oral medication in pediatrics can be challenging due to difficulty with administration and systemic side effects. Topical medication has a potential advantage due to ease of application and amelioration of adverse effects. This study explores our patient experience with transdermal oxybutynin patches (TOP) as a viable alternative to oral oxybutynin.
Patients with neurogenic bladder were identified through the multidisciplinary spinal rehabilitation clinic at Princess Margaret Hospital. Patients identified had trialled TOP and/or oral oxybutynin for greater than 6 weeks and were followed through the clinic. A questionnaire and rating scale was developed for patients to report efficacy, compliance and side effects. Retrospective demographics and outcomes data was collected through phone or face-to-face interview.
27 patients (mean age 10, range 4-18) met inclusion criteria, with 18 having tried both TOP and oral preparations and 9 having tried only TOP. Of the patients that had tried both formulations, 12 (66.6%) preferred TOP. Reasons cited for preference of TOP were ease of use (50%) and fewer side effects (41.7%). 6 participants preferred oral medication, reasons for preference included the patch falling off (50%) and skin irritation (33.3%). Patient- reported efficacy and compliance data was reported on a scale of 1-5. Patient reported control with TOP was 3.85 vs 3.41 with oral (p