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

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.