Relaxation of intestinal bladders by intravesical oxybutynin chloride

Incontinence is a frequent complication of continent urinary diversions and neurogenic bladder augmentations constructed from intestinal segments. Oxybutynin chloride was delivered intravesically and orally to six beagles 9 months after bladders were replaced by tubularized ileum (in three dogs) or sigmorectum (in three dogs). Intravesical oxybutynin produced greater bladder relaxation by urodynamic criteria. Measured oxybutynin chloride concentrations suggested that high tissue levels were achieved at low systemic levels. In two human patients with ileocecal urinary diversions, intravesical oxybutynin chloride decreased bladder pressure and decreased the number and magnitude of superimposed contractions. Intravesical application of oxybutynin chloride may produce local drug levels unachievable by oral administration and may better treat incontinence in patients who intermittently catheterize intestinal bladders or intestinally augmented neurogenic bladders.