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The Effect of Montelukast on Urinary Symptoms in Children With Bladder Pain Syndrome: A Randomized Clinical Trial
Ali Arjmand Shabestari1, Faeze Akbarzadeh2, Fatemeh Dorreh1,3
1Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Insights
Adding Montelukast to oxybutynin significantly reduced pain in children with bladder pain syndrome (BPS). While other urinary symptoms showed no difference, Montelukast improved pain-free outcomes, offering a new therapeutic option.
Area of Science:
- Pediatric Urology
- Pharmacology
- Clinical Medicine
Background:
- Bladder pain syndrome (BPS) significantly impacts children's quality of life.
- Leukotriene receptor antagonists like Montelukast may modulate inflammatory pathways involved in BPS.
- Current treatments for pediatric BPS often have limited efficacy or side effects.
Purpose of the Study:
- To evaluate the efficacy of Montelukast, when added to oxybutynin, in reducing BPS symptoms in children.
- To compare the effects of Montelukast plus oxybutynin versus oxybutynin alone on pain severity and urinary function.
Main Methods:
- A randomized clinical trial was conducted involving children diagnosed with BPS.
- Participants were assigned to either an intervention group (Montelukast + oxybutynin) or a control group (oxybutynin).
- Urinary symptoms (nocturnal enuresis, frequency, incontinence, urgency) and pain severity were assessed at baseline and after 14 days.
Main Results:
- No significant differences were observed between groups for nocturnal enuresis, frequent urination, urinary incontinence, or urinary urgency.
- A significantly higher proportion of children in the Montelukast group reported being pain-free compared to the control group (84.4% vs 56.3%, P = .023).
- The addition of Montelukast to oxybutynin demonstrated a significant reduction in pain severity.
Conclusions:
- Adding Montelukast to oxybutynin therapy offers a significant benefit in pain reduction for children with BPS.
- Montelukast may be a valuable adjunctive treatment for managing pain in pediatric BPS.
- Further research is warranted to explore long-term efficacy and optimal dosing of Montelukast in pediatric BPS.
Abstract:
Montelukast by inhibiting leukotriene receptors in the bladder can prevent the activation of mast cells. We investigated the effectiveness of Montelukast in reducing the symptoms of children with bladder pain syndrome (BPS). In this randomized clinical trial, children were allocated into groups of intervention (Montelukast and oxybutynin) and the control (oxybutynin). At the beginning and after 14 days, questions from mothers of children about their urinary condition were asked about the frequency of nocturnal enuresis, frequent urination, urinary incontinence, urinary urgency, and their pain severity. There was no significant difference between two groups in terms of frequency of nocturnal enuresis, frequent urination, urinary incontinence, and urinary urgency. Regarding the frequency of pain distribution, the frequency of pain-free people in the Montelukast group was higher than control group (84.4% vs 56.3%, P = .023). The results showed that adding Montelukast to oxybutynin has a significant decrease in pain in children with BPS.
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