Treatment with phenoxybenzamine of upper urinary tract complications caused by intravesical obstruction.

Five children in whom reflux and progressive hydronephrosis persisted despite multiple surgical attempts or repair are described. In all cases cystomanometry displayed a marked elevation of the bladder outlet resistance combined with high intravesical pressure values. Therapy with phenoxybenzamine, an alpha-adrenergic blocker, was successful in all cases, restoring a free urine passage of the upper urinary tract and unimpaired voiding preventing urinary diversion which has been considered in some of these children. Although there were no signs of bladder neuropathy, a hyperfunction of the sympathetic innervation as acause for bladder complications is discussed.