Skip to main content

Advertisement

SpringerLink
Log in

Efficacy and safety of anticholinergics for children or adolescents with idiopathic overactive bladder: systematic review and meta-analysis

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Anticholinergics have been established for their efficacy and safety in adults with idiopathic overactive bladder syndrome (OAB-s) but not in children and adolescents. This study was aims to investigate the efficacy and safety of anticholinergics in children and adolescents with idiopathic OAB-s.

Method

A total of nine studies with 11 trials comprising of 1801 subjects (1116 experimental and 685 controls) were included. Inclusion criteria were idiopathic OAB-s in children or adolescents. Overall SMD of change in diurnal urge incontinence per week, change in mean voiding frequency per 24 h, change in mean voided volume, and incidence of adverse events compared with placebo were investigated.

Results

Overall SMD of diurnal urge incontinence per week for the anticholinergic group (experimental group) vs. the placebo group (control group) was − 0.15 (95% CI − 0.31, 0.01). Overall SMD of mean voiding frequency per 24 h was − 0.16 (95% CI − 0.33, 0.02). Overall SMD of mean voided volume was 0.49 (95% CI 0.10, 0.88). The overall incidence of any AEs of anticholinergics compared with placebo was OR = 1.06 (95% CI 0.84–1.34) (p = 0.637). Among each AEs, the only incidence of urinary tract infection showed a higher incidence rate for anticholinergics (OR = 1.92, 95% CI 1.06–3.49) than for placebo.

Conclusions

Apart from oxybutynin, other anticholinergics showed efficacy including an increase in mean voided volume. Moreover, there was no significant difference in the incidence of overall adverse events between anticholinergics and placebo.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Franco I (2016) Overactive bladder in children. Nat Rev Urol 13(9):520–532. https://doi.org/10.1038/nrurol.2016.152

    Article  CAS  PubMed  Google Scholar 

  2. Kalo BB, Bella H (1996) Enuresis: prevalence and associated factors among primary school children in Saudi Arabia. Acta Paediatr 85(10):1217–1222

    Article  CAS  PubMed  Google Scholar 

  3. Butler RJ, Golding J, Northstone K, Team AS (2005) Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU Int 96(3):404–410. https://doi.org/10.1111/j.1464-410x.2005.05640.x

    Article  PubMed  Google Scholar 

  4. Bakker E, van Sprundel M, van der Auwera JC, van Gool JD, Wyndaele JJ (2002) Voiding habits and wetting in a population of 4,332 Belgian schoolchildren aged between 10 and 14 years. Scand J Urol Nephrol 36(5):354–362. https://doi.org/10.1080/003655902320783863

    Article  CAS  PubMed  Google Scholar 

  5. Fitzgerald MP, Thom DH, Wassel-Fyr C, Subak L, Brubaker L, Van Den Eeden SK, Brown JS, Reproductive Risks for Incontinence Study at Kaiser Research G (2006) Childhood urinary symptoms predict adult overactive bladder symptoms. J Urol 175(3 Pt 1):989–993. https://doi.org/10.1016/s0022-5347(05)00416-7

    Article  PubMed  PubMed Central  Google Scholar 

  6. Blais AS, Bergeron M, Nadeau G, Ramsay S, Bolduc S (2016) Anticholinergic use in children: persistence and patterns of therapy. Can Urol Assoc J 10(3–4):137–140. https://doi.org/10.5489/cuaj.3527

    Article  PubMed  PubMed Central  Google Scholar 

  7. Schroder A, Thuroff JW (2010) New strategies for medical management of overactive bladder in children. Curr Opin Urol 20(4):313–317. https://doi.org/10.1097/MOU.0b013e32833aa185

    Article  PubMed  Google Scholar 

  8. Jackson D, Law M, Barrett JK, Turner R, Higgins JP, Salanti G, White IR (2016) Extending DerSimonian and Laird’s methodology to perform network meta-analyses with random inconsistency effects. Stat Med 35(6):819–839. https://doi.org/10.1002/sim.6752

    Article  PubMed  Google Scholar 

  9. Marschall-Kehrel D, Feustel C, Persson de Geeter C, Stehr M, Radmayr C, Sillen U, Strugala G (2009) Treatment with propiverine in children suffering from nonneurogenic overactive bladder and urinary incontinence: results of a randomized placebo-controlled phase 3 clinical trial. Eur Urol 55(3):729–736. https://doi.org/10.1016/j.eururo.2008.04.062

    Article  CAS  PubMed  Google Scholar 

  10. Birder L, de Groat W, Mills I, Morrison J, Thor K, Drake M (2010) Neural control of the lower urinary tract: peripheral and spinal mechanisms. Neurourol Urodyn 29(1):128–139. https://doi.org/10.1002/nau.20837

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Michel MC, Chapple CR (2009) Basic mechanisms of urgency: roles and benefits of pharmacotherapy. World J Urol 27(6):705–709. https://doi.org/10.1007/s00345-009-0446-5

    Article  PubMed  PubMed Central  Google Scholar 

  12. European Medicines Agency (2013) Clinical investigation of medicinal products in the treatment of urinary incontinence. European Medicine Agency. https://www.ema.europa.eu/en/clinical-investigation-medicinal-products-treatment-urinary-incontinence. Accessed 30 May 2019

  13. Lee SD, Chung JM, Kang DI, Ryu DS, Cho WY, Park S (2017) Efficacy and tolerability of solifenacin 5 mg fixed dose in korean children with newly diagnosed idiopathic overactive bladder: a multicenter prospective study. J Korean Med Sci 32(2):329–334. https://doi.org/10.3346/jkms.2017.32.2.329

    Article  CAS  PubMed  Google Scholar 

  14. Newgreen D, Bosman B, Hollestein-Havelaar A, Dahler E, Besuyen R, Sawyer W, Bolduc S, Rittig S (2017) Solifenacin in children and adolescents with overactive bladder: results of a phase 3 randomised clinical trial. Eur Urol 71(3):483–490. https://doi.org/10.1016/j.eururo.2016.08.061

    Article  CAS  PubMed  Google Scholar 

  15. Newgreen D, Bosman B, Hollestein-Havelaar A, Dahler E, Besuyen R, Snijder R, Sawyer W, Rittig S, Bolduc S (2017) Long-term safety and efficacy of solifenacin in children and adolescents with overactive bladder. J Urol 198(4):928–936. https://doi.org/10.1016/j.juro.2017.05.038

    Article  CAS  PubMed  Google Scholar 

  16. Bolduc S, Moore K, Nadeau G, Lebel S, Lamontagne P, Hamel M (2010) Prospective open label study of solifenacin for overactive bladder in children. J Urol 184(4 Suppl):1668–1673. https://doi.org/10.1016/j.juro.2010.03.124

    Article  PubMed  Google Scholar 

  17. Hoebeke P, De Pooter J, De Caestecker K, Raes A, Dehoorne J, Van Laecke E, Vande Walle J (2009) Solifenacin for therapy resistant overactive bladder. J Urol 182(4 Suppl):2040–2044. https://doi.org/10.1016/j.juro.2009.05.100

    Article  CAS  PubMed  Google Scholar 

  18. Nadeau G, Schroder A, Moore K, Genois L, Lamontagne P, Hamel M, Pellerin E, Bolduc S (2014) Long-term use of solifenacin in pediatric patients with overactive bladder: extension of a prospective open-label study. Can Urol Assoc J 8(3–4):118–123. https://doi.org/10.5489/cuaj.1356

    Article  PubMed  PubMed Central  Google Scholar 

  19. Andersson KE (2011) Antimuscarinic mechanisms and the overactive detrusor: an update. Eur Urol 59(3):377–386. https://doi.org/10.1016/j.eururo.2010.11.040

    Article  CAS  PubMed  Google Scholar 

  20. Finney SM, Andersson KE, Gillespie JI, Stewart LH (2006) Antimuscarinic drugs in detrusor overactivity and the overactive bladder syndrome: motor or sensory actions? BJU Int 98(3):503–507. https://doi.org/10.1111/j.1464-410X.2006.06258.x

    Article  CAS  PubMed  Google Scholar 

  21. Ferrara P, D’Aleo CM, Tarquini E, Salvatore S, Salvaggio E (2001) Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida. BJU Int 87(7):674–678

    Article  CAS  PubMed  Google Scholar 

  22. Giramonti KM, Kogan BA, Halpern LF (2008) The effects of anticholinergic drugs on attention span and short-term memory skills in children. Neurourol Urodyn 27(4):315–318. https://doi.org/10.1002/nau.20507

    Article  CAS  PubMed  Google Scholar 

  23. Sommer BR, O’Hara R, Askari N, Kraemer HC, Kennedy WA 2nd (2005) The effect of oxybutynin treatment on cognition in children with diurnal incontinence. J Urol 173(6):2125–2127. https://doi.org/10.1097/01.ju.0000157685.83573.79

    Article  CAS  PubMed  Google Scholar 

  24. Lopez Pereira P, Miguelez C, Caffarati J, Estornell F, Anguera A (2003) Trospium chloride for the treatment of detrusor instability in children. J Urol 170(5):1978–1981. https://doi.org/10.1097/01.ju.0000085667.05190.ad

    Article  CAS  PubMed  Google Scholar 

  25. Nijman RJ, Borgstein NG, Ellsworth P, Djurhuus JC (2005) Tolterodine treatment for children with symptoms of urinary urge incontinence suggestive of detrusor overactivity: results from 2 randomized, placebo controlled trials. J Urol 173(4):1334–1339. https://doi.org/10.1097/01.ju.0000152322.17542.63

    Article  CAS  PubMed  Google Scholar 

  26. Triantafyllidis A, Charalambous S, Papatsoris AG, Papathanasiou A, Kalaitzis C, Rombis V, Touloupidis S (2005) Management of nocturnal enuresis in Greek children. Pediatr Nephrol 20(9):1343–1345. https://doi.org/10.1007/s00467-005-1921-x

    Article  CAS  PubMed  Google Scholar 

  27. Nijman RJ, Borgstein NG, Ellsworth P, Siggaard C (2007) Long-term tolerability of tolterodine extended release in children 5-11 years of age: results from a 12-month, open-label study. Eur Urol 52(5):1511–1516. https://doi.org/10.1016/j.eururo.2007.05.002

    Article  PubMed  Google Scholar 

  28. Neveus T, Tullus K (2008) Tolterodine and imipramine in refractory enuresis; a placebo-controlled crossover study. Pediatr Nephrol 23(2):263–267. https://doi.org/10.1007/s00467-007-0662-4

    Article  PubMed  Google Scholar 

  29. Deng YJ, Ma G, Guo YF, Ge Z, Lu RG, Wang LX, Zhu HB, Chen CJ (2011) Comparisons of efficacy and safety of tolterodine and oxybutynin in children with idiopathic overactive bladder. Zhongguo Dang Dai Er Ke Za Zhi 13(1):26–28

    CAS  PubMed  Google Scholar 

  30. Quintiliano F, Veiga ML, Moraes M, Cunha C, de Oliveira LF, Lordelo P, Bastos Netto JM, Barroso Junior U (2015) Transcutaneous parasacral electrical stimulation vs oxybutynin for the treatment of overactive bladder in children: a randomized clinical trial. J Urol 193(5 Suppl):1749–1753. https://doi.org/10.1016/j.juro.2014.12.001

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was supported by Soonchunhyang University Research Fund (Grant no. 2019-0006).

Author information

Authors and Affiliations

  1. Department of Healthcare Management, Eulji University, Seongnam, South Korea

    Jin-Won Noh

  2. Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

    Jin-Won Noh

  3. Department of Statistics, Graduate School of Chung-Ang University, Seoul, South Korea

    Bora Lee

  4. Department of Urology, College of Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Republic of Korea

    Bora Lee & Jae Heon Kim

Authors
  1. Jin-Won Noh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bora Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jae Heon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JH Kim had full access to all of the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: JH Kim. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: JW Noh and JH Kim. Statistical analysis: JW Noh, B Lee, and JH Kim.

Corresponding author

Correspondence to Jae Heon Kim.

Ethics declarations

Conflict of interest

All authors have completed and submitted the ICMJE Form for disclosure of potential conflicts of interest and none were reported.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

11255_2019_2209_MOESM1_ESM.tif

Supplementary Figure 1. Sensitivity analysis of anticholinergics for urge incontinence episode (A), mean voiding frequency (B), and mean voided volume (C) (TIFF 132 kb)

11255_2019_2209_MOESM2_ESM.tif

Supplementary Figure 2. Cumulative analysis of anticholinergics for mean voiding frequency (A) and mean voided volume (B) (TIFF 163 kb)

Supplementary Figure 3. Funnel plots for voiding frequency per 24 hours and voided volume (TIFF 22 kb)

Supplementary material 4 (DOCX 13 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Noh, JW., Lee, B. & Kim, J.H. Efficacy and safety of anticholinergics for children or adolescents with idiopathic overactive bladder: systematic review and meta-analysis. Int Urol Nephrol 51, 1459–1471 (2019). https://doi.org/10.1007/s11255-019-02209-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-019-02209-y

Keywords

Search

Navigation