Effect of Oxybutynin on Catheter-Related Bladder Discomfort after Cystoplasty in Placenta Accreta Patients

Document Type : Research Paper

Authors

1 Assistant professor , Urology Department, Ghaem Hospital, Mashhad University of Medical Sciences

2 Gynecologist, Ghaem Hospital, Mashhad University of Medical Sciences

3 Resident of Urology, Ghaem Hospital, Mashhad University of Medical Sciences

Abstract

Abstract
Introduction:In a considerable number of pregnant patients with placenta accreta, during cesarian section bladder involment and injury is common .After bladder repairment, urinary catheterization and free drainage for a long time( about three weeks) is needed. Sondage is a source of significant discomfort in these group of patients . Burn sensation, bladder fullness, urgency, and urine leakage are the most common problems. In this cross-sectional retrograde study, we aimed to describe the incidence and severity of the catheter-related bladder discomfort (CRBD) in patients receiving  oxybutynin as  anticholinergic treatment and whom not received this drug as the control group.
Materials & Methods: In about six years period of time since 2012 to 2018 , forty three patients whom had been visited in Mashhad Ghaem Hospital clinic for their bladder injury follow up ,enrolled in this study .Twenty five  (58.2%) patients had received antibiotics and analgesics as the routine regimen (control group) . In addition to the routine regimen 18 (41.8%) patients had received 5 to 15 mg daily oxybutynin oral tablet (Oxybutynin group). During follow up and after about 21 days, patients were asked and evaluated about the severity of catheter related bladder discomfort (CRBD). Oxybutynin had stopped 48 hours before catheter removal.
Results: In Oxybutynin group, all patients described the severity of CRBD as mild to moderate, whereas in control group, for 19 (76%) patients, CRBD was severe and it was moderate in only 6(24%) patients .The most common complication in oxybutynin group was mouth dryness which was expressed severe by only 3(14.4%)  patients  in the first week of treatment. Mouth Dryness was considerably controlled by decreasing the oxybutynin dose and drinking more liquids and especially chewing gum. Constipation was the second one and limited by using high-fiber foods.
Conclusion: In this study we saw that using oral Oxybutynin tablet as an anticholinergic drug could be beneficial for controlling CRBD after cystoplasty in placenta accreta patients.

Keywords

References

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Medical Journal of Mashhad university of Medical Sciences
Volume 61, Issue 6
May and June 2019
Pages 1800-1810

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