What causes overactive bladder (OAB) in children?

Updated: Apr 01, 2019
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

In children, OAB may arise from various etiologies, including neurogenic, anatomic, inflammatory, and idiopathic causes. Neurogenic etiologies include myelomeningocele, cerebral palsy, spinal cord injury, sacral agenesis, and imperforate anus. Twenty-two percent of children with a lumbosacral myelomeningocele have uninhibited bladder contractions. [4] In children with cerebral palsy, an unstable bladder is the most common urologic anomaly.

The most common anatomic abnormality associated with OAB is posterior urethral valves; 24% of males with this condition have OAB. [5] Inflammatory processes in the bladder wall (eg, urinary tract infections [UTIs]) may irritate receptors in the submucosa and detrusor muscle layers and may lead to OAB symptoms. Idiopathic OAB is thought to be secondary to delayed maturation of the reticulospinal pathways and inhibitory centers in the midbrain and cerebral cortex.

In a prospective multicenter study performed in 16 Korean medical school hospitals in 2006, the risk factors for OAB were evaluated. Enuresis, constipation, fecal incontinence, urinary tract infection, and delayed toilet training were considered risk factors associated with OAB. [6]


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