Role of gabapentin in the management of neurogenic overactive bladders: A systematic review

Neurogenic lower urinary tract dysfunction is typically managed through a step-up approach, beginning with anticholinergic medications, progressing to Botulinum toxin injections, and surgical interventions. Gabapentin offers a less invasive option, either as an adjunct to anticholinergics or as a standalone therapy. This systematic review examines gabapentin's efficacy and safety in treating neurogenic overactive bladders (NOAB) in both paediatric and adult populations.To determine gabapentin's effect on reducing bladder pressure, increasing bladder capacity, and alleviating incontinence symptoms in NOAB patients.

A systematic search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane to identify studies on gabapentin for NOAB. Articles were sorted according to PRISMA guidelines, and the risk of bias was assessed using the JBI clinical appraisal tool. Data from the selected articles were synthesized qualitatively.

Of the 116 identified articles, 6 were selected. Two focused on paediatric patients with neural tube defects, while four studies involved adults with conditions like spinal trauma, Parkinson's disease, and multiple sclerosis. Urodynamic parameters improved in four studies, whether gabapentin was used alone or as an adjunct. All 6 studies reported significant improvements and minimal side effects.

While limitations in dosages and study durations hinder a definitive endorsement of gabapentin, the overall positive response across studies suggests its potential efficacy in managing NOAB. Further high-quality randomized controlled trials comparing gabapentin with other treatments and exploring factors related to non-responsiveness are warranted for conclusive insights.