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Transcutaneous parasacral electrical stimulation vs oxybutynin for the treatment of overactive bladder in children: a
Fábio Quintiliano1, Maria Luiza Veiga1, Marília Moraes1
1Division of Pediatric Urology, Department of Urology, Bahia School of Medicine, Salvador, Bahia, Brazil; Divisions of Urology, Departments of Surgery, Federal University of Juiz de Fora and School of Health and Medical Sciences of Juiz de Fora, Juiz de Fora (LFdO, JMBN), Minas Gerais, Brazil.
Insights
Parasacral transcutaneous electrical stimulation and oxybutynin show similar effectiveness for treating pediatric overactive bladder. However, electrical stimulation offers better constipation relief and fewer side effects, while oxybutynin is more effective for reducing urinary frequency.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Pharmacological Treatments
Background:
- Overactive bladder (OAB) significantly impacts children's quality of life.
- Current OAB treatments in children include pharmacological and non-pharmacological approaches.
- Identifying effective and safe treatment options for pediatric OAB is crucial.
Purpose of the Study:
- To compare the effectiveness of parasacral transcutaneous electrical stimulation (PTES) versus oxybutynin for treating overactive bladder in children.
- To evaluate symptom resolution, patient-reported outcomes, and side effect profiles of both treatments.
Main Methods:
- A randomized clinical trial involving pediatric patients diagnosed with overactive bladder.
- Group 1 received PTES with a placebo drug; Group 2 received oxybutynin with sham electrical therapy.
- Outcomes assessed included complete symptom resolution, visual analog scale, dysfunctional voiding score, voiding diaries, Rome III criteria, and side effect frequency.
Main Results:
- Complete symptom resolution occurred in 46% of the PTES group versus 20% in the oxybutynin group (p=0.204).
- Both groups showed significant improvement in dysfunctional voiding scores and voiding diary records.
- PTES demonstrated superior efficacy in improving constipation (100% vs 55%, p=0.031) and had no reported side effects, unlike oxybutynin (58% dry mouth, p=0.002).
Conclusions:
- Parasacral transcutaneous electrical stimulation is a viable and effective alternative to oxybutynin for pediatric overactive bladder.
- PTES offers a favorable side effect profile and benefits for associated constipation.
- Oxybutynin remains effective for reducing urinary frequency but is associated with significant side effects.
Purpose:
We determined the effectiveness of 2 methods to treat overactive bladder in children using intragroup and intergroup comparisons in a randomized clinical trial.
Materials And Methods:
Nine boys and 19 girls with a mean ± SD age of 6.4 ± 2.18 years were randomly divided into group 1-parasacral transcutaneous electrical stimulation with placebo drug and group 2-oxybutynin with sham scapular electrical therapy. Success was assessed by 1) the rate of complete symptom resolution, 2) a visual analog scale of 0 to 10, 3) the dysfunctional voiding score system, 4) voiding diary records, 5) Rome III criteria and 6) side effect frequency in each group.
Results:
A total of 13 and 15 patients were randomized to groups 1 and 2, respectively. Symptoms completely resolved in 6 patients in group 1 (46%) and 3 in group 2 (20%) (p = 0.204). A statistically significant improvement was found in the 2 groups in the dysfunctional voiding score system and voiding diary records. However, no statistically significant difference was found between the groups in the visual analog scale score, voiding frequency, and maximum and mean voided volume (p = 0.295, 0.098, 0.538 and 0.650, respectively). Constipation improved in 100% of group 1 patients but in only 55% in group 2 (p = 0.031 vs 0.073). Group 1 showed no side effects while dry mouth, hyperthermia and hyperemia developed in 58%, 25% and 50% of group 2 patients (p = 0.002, 0.096 and 0.005, respectively). Treatment was discontinued by 13.3% of patients in group 2.
Conclusions:
Parasacral transcutaneous electrical stimulation was as effective as oxybutynin to treat overactive bladder in children. However, transcutaneous parasacral electrical stimulation was more effective against constipation and showed no detectable side effects. Oxybutynin was more effective for decreasing voiding frequency.
