Overactive Bladder in Children Medication

  • Author: Pamela I Ellsworth, MD, FACS; Chief Editor: Edward David Kim, MD, FACS   more...
 
Updated: Jun 7, 2011
 

Medication Summary

Although pharmacologic therapy is one of the mainstays in the treatment of adult overactive bladder (OAB) and the management of neurogenic detrusor overactivity, its role in the treatment of idiopathic OAB in children is less well defined.

Anticholinergic agents are often used in children with OAB when behavioral therapy has failed or as an adjunct to behavioral therapy. Currently, the most commonly used anticholinergic for the treatment of OAB in children is oxybutynin (Ditropan XL).

Other agents used in the treatment of adult OAB have been used in children. Tolterodine (Detrol), a nonselective antimuscarinic agent with a favorable tolerability profile compared with oxybutynin, has been studied in children. However, no pediatric indication is listed in the labeling. Trospium chloride (Sanctura), another agent used in adults, has been used in a small series of children, with doses varying from 10-25 mg/d, divided bid.

Other newer anticholinergic agents used in adult patients with OAB that have not been studied in children include solifenacin (Vesicare) and darifenacin (Enablex).

Next

Anticholinergic Agents

Class Summary

Anticholinergic agents inhibit the binding of acetylcholine to the cholinergic receptor, thereby suppressing involuntary bladder contraction of any etiology. In addition, they increase the volume of the first involuntary bladder contraction, decrease the amplitude of the involuntary bladder contraction, and may increase bladder capacity.

View full drug information

Oxybutynin (Ditropan, Ditropan XL, Oxytrol, Gelnique)

 

Oxybutynin inhibits the action of acetylcholine on smooth muscle and has a direct antispasmodic effect on smooth muscles, increasing bladder capacity and decreasing uninhibited contractions.

Previous
 
Contributor Information and Disclosures
Author

Pamela I Ellsworth, MD, FACS  Associate Professor of Urology, The Warren Alpert Medical School of Brown University; Consulting Staff, University Urological Associates

Pamela I Ellsworth, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Urological Association, Phi Beta Kappa, Society for Fetal Urology, and Society of University Urologists

Disclosure: Pfizer Consulting fee Consulting; Novartis Honoraria Speaking and teaching

Coauthor(s)

Katherine M Callaghan  University of Massachusetts Medical School

Disclosure: Nothing to disclose.

Specialty Editor Board

Gamal Mostafa Ghoniem, MD, FACS  Professor of Urology, Chief, Division of Female Urology, Pelvic Reconstructive Surgery, and Voiding Dysfunction, Department of Urology, University of California, Irvine, School of Medicine

Gamal Mostafa Ghoniem, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urogynecologic Society, American Urological Association, International Continence Society, International Urogynaecology Association, and Society of Urodynamics and Female Urology

Disclosure: Astellas Honoraria Speaking and teaching; Coloplasty Consulting fee Board membership; Uroplasty Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Edward David Kim, MD, FACS  Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association

Disclosure: Lilly Consulting fee Advisor; Astellas Consulting fee Speaking and teaching; Watson Consulting fee Speaking and teaching; Allergan Consulting fee Speaking and teaching

References

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. [Medline].

  2. Franco I. Overactive bladder in children. Part 1: Pathophysiology. J Urol. Sep 2007;178(3 Pt 1):761-8; discussion 768. [Medline].

  3. Fitzgerald MP, Thom DH, Wassel-Fyr C, et al. Childhood urinary symptoms predict adult overactive bladder symptoms. J Urol. Mar 2006;175(3 Pt 1):989-93. [Medline]. [Full Text].

  4. Dator DP, Hatchett L, Dyro FM, Shefner JM, Bauer SB. Urodynamic dysfunction in walking myelodysplastic children. J Urol. Aug 1992;148(2 Pt 1):362-5. [Medline].

  5. Peters CA, Bolkier M, Bauer SB, Hendren WH, Colodny AH, Mandell J, et al. The urodynamic consequences of posterior urethral valves. J Urol. Jul 1990;144(1):122-6. [Medline].

  6. Bloom DA, Seeley WW, Ritchey ML, McGuire EJ. Toilet habits and continence in children: an opportunity sampling in search of normal parameters. J Urol. May 1993;149(5):1087-90. [Medline].

  7. Kuh D, Cardozo L, Hardy R. Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort. J Epidemiol Community Health. Aug 1999;53(8):453-8. [Medline].

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

  9. Järvelin MR, Vikeväinen-Tervonen L, Moilanen I, Huttunen NP. Enuresis in seven-year-old children. Acta Paediatr Scand. Jan 1988;77(1):148-53. [Medline].

  10. Forsythe WI, Redmond A. Enuresis and spontaneous cure rate. Study of 1129 enuretis. Arch Dis Child. Apr 1974;49(4):259-63. [Medline].

  11. Himsl KK, Hurwitz RS. Pediatric urinary incontinence. Urol Clin North Am. May 1991;18(2):283-93. [Medline].

  12. Hellstrom AL, Hanson E, Hansson S, Hjalmas K, Jodal U. Micturition habits and incontinence in 7-year-old Swedish school entrants. Eur J Pediatr. Mar 1990;149(6):434-7. [Medline].

  13. Curran MJ, Kaefer M, Peters C, Logigian E, Bauer SB. The overactive bladder in childhood: long-term results with conservative management. J Urol. Feb 2000;163(2):574-7. [Medline].

  14. van Gool JD, de Jonge GA. Urge syndrome and urge incontinence. Arch Dis Child. Nov 1989;64(11):1629-34. [Medline].

  15. Lettgen B, von Gontard A, Olbing H, Heiken-Lowenau C, Gaebel E, Schmitz I. Urge incontinence and voiding postponement in children: somatic and psychosocial factors. Acta Paediatr. 2002;91(9):978-84; discussion 895-6. [Medline].

  16. Cvitkovic-Kuzmic A, Brkljacic B, Ivankovic D, Grga A. Ultrasound assessment of detrusor muscle thickness in children with non-neuropathic bladder/sphincter dysfunction. Eur Urol. Feb 2002;41(2):214-8; discussion 218-9. [Medline].

  17. Müller L, Bergström T, Hellström M, Svensson E, Jacobsson B. Standardized ultrasound method for assessing detrusor muscle thickness in children. J Urol. Jul 2000;164(1):134-8. [Medline].

  18. Franco I. Overactive bladder in children. Part 2: Management. J Urol. Sep 2007;178(3 Pt 1):769-74; discussion 774. [Medline].

  19. Kjølseth D, Madsen B, Knudsen LM, Nørgaard JP, Djurhuus JC. Biofeedback treatment of children and adults with idiopathic detrusor instability. Scand J Urol Nephrol. Sep 1994;28(3):243-7. [Medline].

  20. Sureshkumar P, Bower W, Craig JC, Knight JF. Treatment of daytime urinary incontinence in children: a systematic review of randomized controlled trials. J Urol. Jul 2003;170(1):196-200; discussion 200. [Medline].

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

  22. Palmer LS, Zebold K, Firlit CF, Kaplan WE. Complications of intravesical oxybutynin chloride therapy in the pediatric myelomeningocele population. J Urol. Feb 1997;157(2):638-40. [Medline].

  23. Ferrara P, D'Aleo CM, Tarquini E, Salvatore S, Salvaggio E. Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida. BJU Int. May 2001;87(7):674-8. [Medline].

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

  25. Lopez Pereira P, Miguelez C, Caffarati J, Estornell F, Anguera A. Trospium chloride for the treatment of detrusor instability in children. J Urol. Nov 2003;170(5):1978-81. [Medline].

  26. Kuo HC. Effect of botulinum a toxin in the treatment of voiding dysfunction due to detrusor underactivity. Urology. Mar 2003;61(3):550-4. [Medline].

  27. Hohenfellner M, Dahms SE, Matzel K, Thüroff JW. Sacral neuromodulation for treatment of lower urinary tract dysfunction. BJU Int. May 2000;85 Suppl 3:10-9; discussion 22-3. [Medline].

  28. Klingler HC, Pycha A, Schmidbauer J, Marberger M. Use of peripheral neuromodulation of the S3 region for treatment of detrusor overactivity: a urodynamic-based study. Urology. Nov 1 2000;56(5):766-71. [Medline].

 
Previous
Next
 
Urodynamic study demonstrating detrusor overactivity.
Differential diagnosis of overactive bladder (OAB).
Uroflow and electromyography (EMG) study demonstrating dysfunctional voiding: staccato flow pattern and failure to relax sphincter during voiding.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.