Oral solifenacin suspension in the management valve bladder: a pilot study

This pilot study aims to evaluate the efficacy, safety, and tolerability of oral suspension form of solifenacin in children with valve bladder.

Children who developed valve bladder after primary posterior urethral valve (PUV) fulguration were prospectively recruited between 2021 and 2025. Inclusion required features of detrusor overactivity, persistent hydronephrosis, or daytime wetting, with exclusion of residual valves/ infection. Solifenacin suspension was administered at 0.07 mg/kg once daily for 12 months. Subjective parameters included voiding frequency, wetting episodes, and side effects. Objective measures included voided volume as a percentage of age-adjusted expected bladder capacity (VV/EBC), detrusor pressure (Pdet‑max), maximum cystometric capacity (MCC), bladder compliance, Society for Fetal Urology (SFU) hydronephrosis grade, and ureteral diameter.

A total of 47 children with a median age of 3 (0.5-5) years presenting with valve bladder features were administered oral solifenacin suspension. At a median follow-up of 16 months, urinary frequency decreased significantly from 12.8 to 7.4 episodes/day (p = 0.001); wetting episodes declined from 4.7 to 1.8/day (p = 0.01); VV/EBC improved from 34% to 60% (p = 0.001); SFU hydronephrosis grade reduced from 3.5 to 2.8 (p = 0.003), ureteral diameter from 11.6 mm to 10.2 mm (p = 0.039). Urodynamic assessment showed a significant decline in Pdet-max from 39.2 to 29.3 (p = 0.001), alongside significant improvements in mean bladder compliance/ cystometric capacity. Treatment was well tolerated, with no major adverse effects.

This pilot study reports the efficacy, safety, and tolerability of oral suspension form of solifenacin in children with valve bladder. Further larger studies are warranted.