TY - THES ID - 138341825 TI - Can oral fesoterodine be an alternative for intravesical oxybutynin instillations in children with neuropathic bladder dysfunction? AU - De Coster, Katrien AU - Bogaert, Guy AU - De Ridder, Dirk AU - Jansen, Katrien AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de specialistische geneeskunde (oud programma) (Leuven) PY - 2019 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:138341825 AB - A low-pressure bladder in children with neuropathic bladder dysfunction can be achieved using anticholinergic medication. Due to the significant side effects of oral oxybutynine, our patients are treated with daily intravesical oxybutynin instillations. Newer oral anticholinergic medication, such as fesoterodine, claim to have fewer side effects in a once daily formulation. Because once-daily oral intake is easier than performing twice-daily intravesical instillations, we studied the effects of switching from intravesical oxybutynin to oral fesoterodine and compared the clinical response, urodynamic parameters and side effects. 20 children (11girls-9boys, 4-17yr) with neuropathic bladder dysfunction who perform clean intermittent catheterization and use intravesical oxybutynin instillations twice daily were included in this prospective pilot study. Voiding diary, behavioral checklist, urodynamic investigation, vital signs and blood sample were evaluated at baseline during treatment with intravesical oxybutynin and repeated after 40 days of oral fesoterodine. 13/20(65%) children showed an identical objective dryness (pad-test), 2/20(10%) improved and 5/20(25%) got worse. 7/20(35%) children reported equal dryness, 7/20(35%) reported improvement and 6/20(30%) reported that it got worse. From an urodynamic perspective, 13/20(65%) children remained identical, 3/20(15%) improved and 4/20(20%) got worse. 4/20(20%) children reported a light to moderate dry mouth, 1/20(5%) an headache, 1/20(5%) behavioral changes during fesoterodine administration, 1/20(5%) an increased appetite, 1/20(5%) nausea and 1/20(5%) hot flushes. The urodynamics after 40 days of fesoterodine were in 16/20(80%) identical or better. Fesoterodine could be a safe alternative for oxybutynin instillations in children with neuropathic bladder dysfunction. ER -