New treatment of urgency-frequency syndrome in female: Oxybutynin bladder instillation and nasal desmopressine (DDAVP)

In painful bladder syndrome of phlogistic outcome, diagnostic assessment is able to distinguish between bacterial and non bacterial cystitis and endoscopy to evaluate the presence of leucoplasic trigonitis. In absence of infection or leucoplasia we propose the following management: bladder instillation (twice a week for a month) with oxybutynin 20 mg in 20 cc of saline solution. Desmopressine (0,2 cc by nasal drops) three hours before irrigation. On 12 patients all were cured at one year follow up even if 40% needed a second treatment. No side effects were described. Urine flow prevents effectiveness of direct administration of drugs in bladder. Oxybutynin is otherwise not long tolerated for well known side effects. The association with DDAVP (Desmopressine) makes the treatment reliable.