Efficacy and Tolerability of Anticholinergics in Korean Children with Overactive Bladder: A Multicenter Retrospective Study

Abstract

We investigated the efficacy and tolerability of various anticholinergics in Korean children with non-neurogenic overactive bladder (OAB). A total of 326 children (males:females= 157:169) aged under 18 yr (mean age 7.3±2.6 yr) who were diagnosed with OAB from 2008 to 2011 were retrospectively reviewed. The mean duration of OAB symptoms before anticholinergic treatment was 16.9±19.0 months. The mean duration of medication was 5.6±7.3 months. Urgency urinary incontinence episodes per week decreased from 1.9±3.1 to 0.4±1.5 times (P<0.001). The median voiding frequency during daytime was decreased from 9.2±5.4 to 6.3±4.2 times (P<0.001). According to 3-day voiding diaries, the maximum and average bladder capacity were increased from 145.5±66.9 to 196.8±80.3 mL and from 80.8±39.6 to 121.8±56.5 mL, respectively (P<0.001). On uroflowmetry, maximum flow rate was increased from 17.6±8.4 to 20.5±8.2 mL/sec (P<0.001). Adverse effects were reported in 14 (4.3%) children and six children (1.8%) discontinued medication due to adverse effects. Our results indicate that anticholinergics are effective to improve OAB symptoms and tolerability was acceptable without severe complications in children.

Efficacy and Tolerability of Solifenacin 5 mg Fixed Dose in Korean Children with Newly Diagnosed Idiopathic Overactive Bladder: a Multicenter Prospective Study

“…We think that OAB patients' groups included the MBC of unimproved patients after treatment unlike healthy population. Therefore, the above-mentioned retrospective Korean study presented results similar to those of our current study, as the MBC was significantly increased from 145.5 ± 66.9 to 196.8 ± 80.3 mL (13). …”

“…The prevalence of pediatric OAB is relatively high (16.6% in children between 5 and 13 years of age), although it is slightly lower than the rate in adults in Korea (12). Therefore, many urologic or pediatric doctors have adopted the use of various anticholinergics, including solifenacin (13). However, there have been few reports regarding the efficacy of solifenacin for newly diagnosed idiopathic OAB in children.…”

“…In a study of 72 children (27 with a neurogenic bladder) with OAB refractory to oxybutynin or tolterodine, solifenacin was an effective alternative to improve symptoms (5). In a recent Korean retrospective study, solifenacin among various anticholinergics had a 66.7% improvement rate (13). …”

“…According to a previous Korean study that included 326 children with OAB, all AEs occurred in only 14 (4.3%) children. 6 of whom (1.8%) had interrupt to their medication as a result (13). This lower AE incidence, similar to that (6.5%) reported in the study of Hoebeke et al (7) may have been caused by the retrospective nature of the analyses, as compared with our current prospective study, i.e., it is possible that not all AEs were recorded in these earlier reports.…”

Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem

“…Up to 40% of children with OAB do not respond the anticholinergics. 27 With a different mechanism of action, mirabegron, a β3-adrenoceptor agonist, appears to be a safe and effective alternative for treating refractory OAB in children. 28 This new medication has also been proposed as an adjuvant drug in combination with solifenacin for pediatric cases refractory to anticholinergics alone.…”