Neharkar Diksha, Pande Abhay H, Peters Nitin James, Singh Jitender, Medhi Bikash, Prakash Ajay, Kanojia Ravi P, Solanki Shailesh, Dogra Shivani, Mahajan J K
Department of Medical Device, National Institute of Pharmaceutical Education and Research, SAS Nagar, Punjab, 160062, India.
Department of Biotechnology, National Institute of Pharmaceutical Education and Research, SAS Nagar, Punjab, 160062, India.
Int Urol Nephrol. 2025 Jul 21. doi: 10.1007/s11255-025-04671-3.
Overactive bladder (OAB) is a common condition in children, affecting 5-12% of children between the ages of 5 and 10 years. It is characterized by urinary urgency, frequency, and nocturia, often leading to incontinence. OAB significantly impacts a child's emotional and social development, causing anxiety, low self-esteem, and social withdrawal. Oxybutynin is the standard treatment for overactive bladder in children, but side effects like dry mouth, constipation, and cognitive issues can make it difficult for patients to stick with the therapy.
This study systematically reviewed and analyzed existing research to evaluate and compare the effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) versus oxybutynin for treating overactive bladder in children. We performed an electronic search of PubMed, Cochrane, and other databases up to April 2023 to identify randomized controlled trials (RCTs) that reported outcomes related to symptom improvement and adverse effects in children with OAB. We included studies based on the PICO criteria: pediatric patients (under 18 years), OAB treatment (TENS or Oxybutynin), and outcomes such as urinary urgency and incontinence. The risk ratios were calculated to compare the two treatments, and heterogeneity was assessed using the I statistics.
The search found six relevant studies and three of these were suitable for the meta-analysis. The results showed that TENS was much more effective than oxybutynin in improving symptoms, with a risk ratio of 1.93 (95% CI 1.35-2.74). TENS also caused fewer side effects compared to oxybutynin, with a risk ratio of 0.09 (95% CI 0.03-0.30). There was no variation between the studies (I = 0), indicating that the results were consistent across all trials.
TENS has been shown to be both more effective and safer than oxybutynin for treating overactive bladder in children. It leads to greater improvement in symptoms and is linked to fewer side effects. These results indicate that TENS may be a better option, especially for children who have difficulty tolerating medication due to adverse reactions.
膀胱过度活动症（OAB）在儿童中较为常见，5至10岁儿童的发病率为5%至12%。其特征为尿急、尿频和夜尿症，常导致尿失禁。OAB对儿童的情感和社交发展有显著影响，会引起焦虑、自卑和社交退缩。奥昔布宁是治疗儿童膀胱过度活动症的标准药物，但口干、便秘和认知问题等副作用可能使患者难以坚持治疗。
本研究系统回顾并分析了现有研究，以评估和比较经皮电神经刺激（TENS）与奥昔布宁治疗儿童膀胱过度活动症的有效性和安全性。我们在截至2023年4月的PubMed、Cochrane及其他数据库中进行了电子检索，以识别报告了与OAB儿童症状改善和不良反应相关结果的随机对照试验（RCT）。我们根据PICO标准纳入研究：儿科患者（18岁以下）、OAB治疗（TENS或奥昔布宁）以及尿急和尿失禁等结果。计算风险比以比较两种治疗方法，并使用I统计量评估异质性。
检索发现六项相关研究，其中三项适合进行荟萃分析。结果显示，TENS在改善症状方面比奥昔布宁有效得多，风险比为1.93（95%CI 1.35 - 2.74）。与奥昔布宁相比，TENS引起的副作用也更少，风险比为0.09（95%CI 0.03 - 0.30）。各研究之间无差异（I = 0），表明所有试验的结果一致。
已证明TENS在治疗儿童膀胱过度活动症方面比奥昔布宁更有效且更安全。它能使症状得到更大改善，且副作用更少。这些结果表明，TENS可能是更好的选择，尤其是对于因不良反应难以耐受药物的儿童。
