What is the prognosis of 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

The natural history of OAB in children is unknown. Similarly, data on the optimal duration of therapy limited are limited. OAB in children is not believed to be a chronic condition; however, little long-term information is available.

Curran et al, in a study of the long-term results of conservative treatment in children with idiopathic detrusor overactivity, reported that the average time to resolution of symptoms was 2.7 years. The authors noted that children with very small or large bladders were less likely to benefit from conservative management. Age and gender were not significant predictors of resolution, although symptom resolution was more likely in girls than in boys. [15]

Some of the consequences of OAB result from the child’s voluntary attempts to maintain continence during the involuntary detrusor contractions. These coping mechanisms, including forceful contractions of the external sphincter and squatting maneuvers to produce perineal compression, may lead to functional and morphologic changes in the bladder, which can increase the child’s risk of urinary tract infections (UTIs) and vesicoureteral reflux.

Frequent voluntary contractions of the pelvic floor muscles may also lead to postponement of defecation. Constipation and fecal soiling are often identified in children with OAB. Greater than 50% of children with lower urinary tract symptoms evaluated in a tertiary referral center fulfilled diagnostic criteria for functional defecation disorders. [16]

In addition, symptoms of pediatric OAB and urinary incontinence may lead to embarrassment in the child. The child may be inappropriately labeled as having a psychological problem. Children with OAB may refrain from social activities, in fear of wetting and of letting others know how frequently they void. Difficulties may develop between the child and the child’s peers, parents, or both.


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