Efficacy and safety of transcutaneous electrical nerve stimulation versus oxybutynin in the treatment of overactive bladder in children: a systematic review and meta-analysis.

BACKGROUND

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.

METHODS

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 I2 statistics.

RESULTS

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 (I2 = 0), indicating that the results were consistent across all trials.

CONCLUSION

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.