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11–14 APRIL, 2018, HELSINKI, FINLAND
08:13–08:16
S21-2 (PP)
EFFICACY AND SAFETY OF TRANSDERMAL OXYBUTYNIN
VERSUS ORAL OXYBUTYNIN IN MANAGEMENT
OF PAEDIATRIC NEUROPATHIC BLADDER
Emily RICE
1
, Laura WATKINS
2
, Gowri SIVALINGAM
2
, Maddison BURMAZ
1
, Anna
THETFORD
3
, Elizabeth THOMSON
3
, Emma RICHARDSON
4
, Jane VALENTINE
4
,
Anna GUBBAY
4
, Gavan HOTANA
4
, Katherine LANGDON
4
, Naeem SAMNAKAY
2
,
Andrew BARKER
2
and Japinder KHOSA
2
1) University of Western Australia, School of Medicine, Dentistry and Health Science, Crawley, AUSTRALIA - 2) Princess
Margaret Hospital, Department of Urology, Subiaco, AUSTRALIA - 3) Princess Margaret Hospital, Clinical Nurse
Specialist, Multidisciplinary Spinal Clinic, Subiaco, AUSTRALIA - 4) Princess Margaret Hospital, Department
of Rehabilitation Medicine, Subiaco, AUSTRALIA
PURPOSE
To compare the patient experience of transdermal (TOP) versus oral oxybutynin in paediatric
patients with neuropathic bladder.
MATERIAL AND METHODS
Patients with neuropathic bladder were identified via the multidisciplinary spinal rehabilitation clinic.
Patients had trialled TOP and/or oral oxybutynin for greater than 6 weeks. Aquestionnaire and rating
scale was developed to report efficacy, compliance and side effects. Retrospective demographics
and outcomes data was collected through phone or face-to-face interview.
RESULTS
27 patients (mean age 10) met inclusion criteria, with 18 having tried both TOP and oral prepara-
tions and 9 having tried only TOP. Of the patients that had tried both formulations, 12 (66.6 %)
preferred TOP. Reasons for preference were ease of use (50 %) and fewer side effects (41.7 %).
6 participants preferred oral medication, reasons cited included patch falling off (50 %) and skin
irritation (33.3 %). Patient reported efficacy and compliance data was reported on a scale of
1–5 (optimal). Patient reported control with TOP was 3.85 vs 3.41 for oral (p <0.1). Compliance was
reported in terms of ease of use and frequency of missed doses. TOP was missed less frequently
(1.89 vs 2.59, p <0.05) and found to be easier to use (4.33 vs 3.70, p <0.1). Of those taking oral
medication, 38.9 % reported systemic side effects at least ‘somewhat' bothersome compared to
only 14.8 % of those using TOP. 25.9 % of those using TOP reported local side effects that were at
least ‘somewhat' bothersome (redness or itch at application site).
CONCLUSIONS
TOP has better patient compliance and reported efficacy compared to the oral formulation in this
population. It is the preferred formulation due to ease of use and minimal side effects. Topical
oxybutynin is a good alternative to oral medication in children with neuropathic bladder.