What is the long-term monitoring for treatment 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

Behavioral therapy is an important component in the management of OAB, and clinicians should ensure that such regimens are being followed for maximal response.

Although the urodynamic effects of anticholinergic agents occur within 24 hours of dosing, the clinical effects tend to take longer. The authors recommend that an individual remain on an anticholinergic agent for at least 2-4 weeks before determining whether the medication is effective. Furthermore, in individuals who note some response to therapy, improvement may increase throughout the first month of therapy. Thus, the effectiveness of the medication should be evaluated.

In children who respond to anticholinergic therapy, the child should remain on therapy for 3-6 months before attempting to wean off the therapy. If the weaning fails, the child should return to the dose that kept his or her symptoms controlled for an additional 3-6 months before attempting another trial of weaning.

In children who are refractory to behavioral therapy and anticholinergic therapy, further evaluation is indicated. Urodynamic studies are helpful to evaluate bladder and sphincteric function in these children. In addition, children who do not respond to therapy should be reassessed to rule out an underlying neurologic etiology. [49]


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