Abstract
Childhood urinary urgency and frequency are common and can negatively affect self-esteem and quality of life. As compared to adults, there is an increased focus on the diagnosis of overlapping bowel and bladder dysfunction in children. Here, we will review a framework for management as well as recent research. While not FDA approved, newer research has shown benefits with clinic neuromodulation, previously unstudied anticholinergics, mirabegron, multiple drug regimens, and botulinum toxin A in children. The management of overactive bladder in children is typically approached in a step-wise manner starting first with conservative therapies including treatment of constipation or stool retention, avoidance of bladder irritants, and modification of fluid intake. Biofeedback and pelvic floor exercises can also be helpful. For refractory cases, anticholinergic medications have been utilized with only oxybutynin being FDA approved for use in children over 5 years of age without neurologic detrusor overactivity.
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