Intravesical oxybutynin therapy for patients with neurogenic detrusor overactivity: a systematic review and meta-analysis.

PURPOSE: To evaluate the effectiveness and safety of intravesical oxybutynin therapy for patients with neurogenic detrusor overactivity. METHODS: A systematic search in PubMed, MEDLINE, EMBASE, ClinicalTrial.gov, and Cochrane Controlled Trials Register was conducted from 1990 to 2021. Nineteen studies were included for analysis, of which 392 patients including both adults and children were treated with intravesical oxybutynin. The analysis was performed by Cochrane RevMan® software, version 5.3. The primary outcomes were maximum bladder capacity (MBC), detrusor pressure at MBC, and bladder compliance. The secondary outcomes were episodes of urinary incontinence and side effects. RESULTS: MBC displayed an increase of 77.8 ml (95% CI 56.9 to 98.7) in kids, 110.8 ml (95% CI 58.95 to 162.7) in adults, respectively. Detrusor pressure at MBC demonstrated an improvement of - 18.8 cm H2O (95% CI - 26.2 to - 11.3) in kids, - 23.2 cm H2O (95% CI - 32.6 to - 13.8) in adults, respectively. The bladder compliance increased 5.8 ml/cm H2O (95% CI 3.4 to 8.1) among kids. The mean percentage of patients "dry or improved" after treatment accounted for 76.9% in adults and 74.6% in kids, respectively. Among all patients, 53 (13.5%) reported side effects, 80 (20.4%) discontinued this treatment, 26 (6.6%) withdrew because of side effects, and 35 (8.9%) quit due to inconvenience. CONCLUSION: Intravesical oxybutynin treatment could be a feasible treatment for both adults and children with neurogenic detrusor overactivity, because of its good effect and less side effects.