Skip to main content
SpringerLink
Log in

Considerations in Pediatric Overactive Bladder

  • Chapter
  • First Online:
Contemporary Pharmacotherapy of Overactive Bladder

Abstract

Overactive bladder is a term used to describe the symptoms of urgency with or without urgency incontinence that is not the direct result of a known neurologic abnormality. This troublesome condition has a prevalence of as high as 15–20% of the pediatric population, with 2–4% of 7-year-old children reporting incontinence episodes at least once a week. The main objectives of treatment are to normalize the micturition pattern, bladder and pelvic floor overactivity, and cure incontinence. Treatment follows a stepwise, multimodal approach including behavioral modification, adjunctive biofeedback, and in refractory cases, pharmacotherapy. This review will outline the pharmacologic treatment options for pediatric overactive bladder in cases where conservative management has proven unsuccessful.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children’s Continence Society. Neurourol Urodyn. 2016;35(4):471–81.

    Article  Google Scholar 

  2. Nijman R, Tekgul S, Chase J, Bael A, Austin P, von Gontard A. Diagnosis and management of urinary incontinence in childhood. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence, 5th ed. 5th International Consultation on Incontinence, Paris, February; 2012. p. 729–826. The International Continence Society (ICS) and the International Consultation on Urological Diseases (ICUD); 2013.

    Google Scholar 

  3. Järvelin MR, Vikeväinen-Tervonen L, Moilanen I, Huttunen NP. Enuresis in seven-year-old children. Acta Paediatr Scand. 1998;77(1):148–53.

    Article  Google Scholar 

  4. Sureshkumar P, Craig JC, Roy LP, Knight JF. Daytime urinary incontinence in primary school children: a population-based survey. J Pediatr. 2000;137(6):814–8.

    Article  CAS  Google Scholar 

  5. Kajiwara M, Inoue K, Kato M, Usui A, Kurihara M, Usui T. Nocturnal enuresis and overactive bladder in children: an epidemiological study. Int J Urol. 2006;13(1):36–41.

    Article  Google Scholar 

  6. Chung JM, Lee SD, Kang DI, Kwon DD, Kim KS, Kim SY, et al.; Korean Enuresis Association. Prevalence and associated factors of overactive bladder in Korean children 5–13 years old: a nationwide multicenter study. Urology 2009;73(1):63–7; discussion 68-9.

    Article  Google Scholar 

  7. Hellstrom AL, Hjalmas K, Jodal U. Rehabilitation of the dysfunctional bladder in children: method and 3-year follow-up. J Urol. 1987;138(4):847–9.

    Article  CAS  Google Scholar 

  8. Halliday S, Meadow SR, Berg I. Successful management of daytime enuresis using alarm procedures: a randomly controlled trial. Arch Dis Child. 1987;62(2):132–7.

    Article  CAS  Google Scholar 

  9. Vasconcelos M, Lima E, Caiafa L, Noronha A, Cangussu R, Gomes S, et al. Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a randomized study. Pediatr Nephrol. 2006;21(12):1858–64.

    Article  Google Scholar 

  10. Kroll P. Pharmacotherapy for pediatric neurogenic bladder. Pediatr Drugs. 2017;19(5):463–78.

    Article  Google Scholar 

  11. Guay DR. Clinical pharmacokinetics of drugs used to treat urge incontinence. Clin Pharmacokinet. 2003;42(14):1243–85.

    Article  CAS  Google Scholar 

  12. Blais AS, Bergeron M, Nadeau G, Ramsay S, Bolduc S. Anticholinergic use in children: persistence and patterns of therapy. Can Urol Assoc J. 2016;10(3–4):137–40.

    Article  Google Scholar 

  13. Wagg A, Compion G, Fahey A, Siddiqui E. Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int. 2012;110(11):1767–74.

    Article  CAS  Google Scholar 

  14. Gish P, Mosholder AD, Truffa M, Johann-Liang R. Spectrum of central anticholinergic adverse effects associated with oxybutynin: comparison of pediatric and adult cases. J Pediatr. 2009;155(3):432–4.

    Article  CAS  Google Scholar 

  15. Robinson D, Giarenis I, Cardozo L. New developments in the medical management of overactive bladder. Maturitas. 2013;76(3):225–9.

    Article  CAS  Google Scholar 

  16. Buser N, Ivic S, Kessler TM, Kessels AG, Bachmann LM. Efficacy and adverse events of antimuscarinics for treating overactive bladder: network meta-analyses. Eur Urol. 2012;62(6):1040–60.

    Article  CAS  Google Scholar 

  17. Madhuvrata P, Cody JD, Ellis G, Herbison GP, Hay-Smith EJ. Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev. 2012;18(1):CD005429.

    Google Scholar 

  18. Novara G, Galfano A, Secco S, D’Elia C, Cavalleri S, Ficarra V, Artibani W. A systematic review and meta-analysis of randomized controlled trials with antimuscarinic drugs for overactive bladder. Eur Urol. 2008;54(4):740–63.

    Article  CAS  Google Scholar 

  19. Chang SJ, Van Laecke E, Bauer SB, von Gontard A, Bagli D, Bower WF, et al. Treatment of daytime urinary incontinence: a standardization document from the International Children’s Continence Society. Neurourol Urodyn. 2017;36(1):43–50.

    Article  Google Scholar 

  20. Baek M, Kang JY, Jeong J, Kim DK, Kim KM. Treatment outcomes according to neuropathic bladder sphincter dysfunction type after treatment of oxybutynin chloride in children with myelodysplasia. Int Urol Nephrol. 2013;45(3):703–9.

    Article  CAS  Google Scholar 

  21. Youdim K, Kogan BA. Preliminary study of the safety and efficacy of extended-release oxybutynin in children. Urology. 2002;59(3):428–32.

    Article  Google Scholar 

  22. Cartwright PC, Coplen DE, Kogan BA, Volinn W, Finan E, Hoel G. Efficacy and safety of transdermal and oral oxybutynin in children with neurogenic detrusor overactivity. J Urol. 2009;182(4):1548–54.

    Article  CAS  Google Scholar 

  23. Franco I, Horowitz M, Grady R, Adams RC, De Jong T, Lindert K, Albrecht D. Efficacy and safety of oxybutynin in children with detrusor hyperreflexia secondary to neurogenic bladder dysfunction. J Urol. 2005;173(1):221–5.

    Article  CAS  Google Scholar 

  24. Noronha-Blob L, Kachur JF. Enantiomers of oxybutynin: in vitro pharmacological characterization at M1, M2 and m3 muscarinic receptors and in vivo effects on urinary bladder contraction, mydriasis and salivary secretion in guinea pigs. J Pharmacol Exp Ther. 1991;256(2):562–7.

    CAS  PubMed  Google Scholar 

  25. Ramsay S, Bolduc S. Overactive bladder in children. Can Urol Assoc J. 2017;1(1–2 Suppl 1):S74–9.

    Article  Google Scholar 

  26. Curran MJ, Kaefer M, Peters C, Logigian E, Bauer SB. The detrusor overactivity in childhood: long-term results with conservative management. J Urol. 2000;163(2):574–7.

    Article  CAS  Google Scholar 

  27. Gleason JM, Daniels C, Williams K, Varghese A, Koyle MA, Bägli DJ, et al. Single-center experience with oxybutynin transdermal system (patch) for the management of symptoms related to non-neuropathic overactive bladder in children: an attractive, well-tolerated alternative form of administration. J Pediatr Urol. 2014;10(4):753–7.

    Article  Google Scholar 

  28. Greenfield SP, Fera M. The use of intravesical oxybutynin chloride in children with neurogenic bladder. J Urol. 1991;146(2 Pt 2):532–4.

    Article  CAS  Google Scholar 

  29. Ellsworth PI, Borgstein NG, Nigman RJ, Reddy PP. Use of tolterodine in children with neurogenic detrusor overactivity: relationship between dose and urodynamic response. J Urol. 2005;174(4 Pt 2):1647–51.

    Article  CAS  Google Scholar 

  30. Goessl C, Sauter T, Michael T, Berge B, Staehler M, Miller K. Efficacy and tolerability of tolterodine in children with detrusor hyperreflexia. Urology. 2000;55(3):414–8.

    Article  CAS  Google Scholar 

  31. Hjälmås K, Hellström AL, Mogren K, Läckgren G, Stenberg A. The overactive bladder in children: a potential future indication for tolterodine. BJU Int. 2001;87(6):569–74.

    Article  Google Scholar 

  32. Bolduc S, Upadhyay J, Payton J, Bagli DJ, McLorie GA, Khoury AE, Farhat W. The use of tolterodine in children after oxybutynin failure. BJU Int. 2003;91(4):398–401.

    Article  CAS  Google Scholar 

  33. Nijman RJ, Borgstein NG, Ellsworth P, Djurhuus JC. Tolterodine treatment for children with symptoms of urinary urge incontinence suggestive of detrusor overactivity: results from 2 randomized, placebo controlled trials. J Urol. 2005;173(4):1334–9.

    Article  CAS  Google Scholar 

  34. Nijman RJ, Borgstein NG, Ellsworth P, Siggaard C. Long-term tolerability of tolterodine extended release in children 5–11 years of age: results from a 12-month, open-label study. Eur Urol. 2007;52(5):1511–6.

    Article  Google Scholar 

  35. Reinberg Y, Crocker J, Wolpert J, Vandersteen D. Therapeutic efficacy of extended release oxybutynin chloride, and immediate release and long acting tolterodine tartrate in children with diurnal urinary incontinence. J Urol. 2003;169(1):317–9.

    Article  CAS  Google Scholar 

  36. Bolduc S, Moore K, Nadeau G, Lebel S, Lamontage P, Hamel M. Prospective open label study of solifenacin for overactive bladder in children. J Urol. 2010;184(4 Suppl):1668–73.

    Article  Google Scholar 

  37. Hoebeke P, De Pooter J, De Caestecker K, Raes A, Dehoorne J, Van Laecke E, Vande WJ. Solfenacin for therapy resistant overactive bladder. J Urol. 2009;182(4 Suppl):2040–4.

    Article  CAS  Google Scholar 

  38. Lopez Pereira P, Miguelez C, Caffarati J, Estornell F, Anduera A. Trospium chloride for the treatment of detrusor instability in children. J Urol. 2003;170(5):1978–81.

    Article  CAS  Google Scholar 

  39. Marschall-Kehrel D, Feustel C, Persson de Geeter C, Stehr M, Radmayr C, Sillén U, Strugala G. Treatment with propiverine in children suffering from non-neurogenic overactive bladder and urinary incontinence: results of a randomized, placebo-controlled, phase 3 clinical trial. Eur Urol. 2009;55(3):729–36.

    Article  CAS  Google Scholar 

  40. Nadeau G, Schröder A, Moore K, Genois L, Lamontagne P, Hamel M, et al. Double anticholinergic therapy for refractory neurogenic and nonneurogenic detrusor overactivity in children: long-term results of a prospective, open-label study. Can Urol Assoc J. 2014;8(5–6):175–80.

    Article  Google Scholar 

  41. Fahmy A, Youssif M, Rhashad H, Mokhless I, Mahfouz W. Combined low-dose antimuscarinics for refractory detrusor over-activity in children. J Ped Urol. 2016;12(4):219.e1–5.

    Article  CAS  Google Scholar 

  42. Blais AS, Nadeau G, Moore K, Genois L, Bolduc S. Prospective pilot study of mirabegron in pediatric patients with overactive bladder. Eur Urol. 2016;70(1):9–13.

    Article  Google Scholar 

  43. Morin F, Blais AS, Nadeau G, Moore K, Genois L, Bolduc S. Dual therapy for refractory overactive bladder in children: a prospective open-label study. J Urol. 2017;197(4):1158–63.

    Article  Google Scholar 

  44. Apostolidis A, Dasgupta P, Denys P, Elneil S, Fowler CJ, Giannantoni A, et al.; European Consensus Panel. Recommendations on the use of onabotulinum toxin in the treatment of lower urinary tract disorders and pelvic floor dysfunctions: a European consensus report. Eur Urol 2009;55(1):100–19.

    Google Scholar 

  45. Schulte-Baukloh H, Michael T, Sturzebecher B, Knispel HH. Botulinum-A toxin detrusor injection as a novel approach in the treatment of bladder spasticity in children with neurogenic bladder. Eur Urol. 2003;44(1):139–43.

    Article  CAS  Google Scholar 

  46. Hoebeke P, De Caestecker K, Vande Walle J, Dehoorne J, Raes A, Verleyen P, Van Laecke E. The effect of botulinum-A toxin in incontinent children with therapy resistant overactive detrusor. J Urol. 2006;176(1):328–30.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Alyssa Greiman & Andrew A. Stec

Authors
  1. Alyssa Greiman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew A. Stec
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew A. Stec .

Editor information

Editors and Affiliations

  1. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Lindsey Cox

  2. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Eric S. Rovner

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Greiman, A., Stec, A.A. (2019). Considerations in Pediatric Overactive Bladder. In: Cox, L., Rovner, E. (eds) Contemporary Pharmacotherapy of Overactive Bladder. Springer, Cham. https://doi.org/10.1007/978-3-319-97265-7_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97265-7_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97264-0

  • Online ISBN: 978-3-319-97265-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation