الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Treatment of OAB in children starts with behavioral treatment; its failure necessitates adding a second line treatment, which can be either medical treatment or non-invasive electric stimulation. The first line medical treatment is anticholinergics, which are comparable in their efficacy and safety profiles.
Solifenacin succinate is a selective anticholinergic that had some evidence of effectiveness among adult patients, but this evidence yet to be confirmed in children. It has been used off-label for OAB in children, and recently gained FDA approval for treatment of neurogenic OAB in pediatric patients as young as two years of age.
Electric stimulation for treating OAB has many forms, the safest and easiest of which is PS-TENS. This form of electrotherapy has been found to improve OAB symptoms among treatment-naïve and refractory cases. To the best of our knowledge, no studies compared PS-TENS with Solifenacin succinate in children with OAB.
Our study involved 3 groups of children with OAB; first group is treatment-naïve children receiving PS-TENS, second group is treatment-naïve children receiving solifenacin, and third group is treatment-refractory children receiving PS-TENS. The course of treatment was 12 weeks, and children were assessed by objective parameters including voiding diary, symptom scores, ultrasound, uroflowmetry with EMG, with the addition of cystometry for the refractory group.
The three study groups were comparable regarding sociodemographic data, clinical presentation and initial symptom scores. The mean age was 7.9 ± 1.3, 8.1 ± 1.8 and 8.8 ± 1.6 years for the three groups respectively. Number of children with day-time incontinence was significantly reduced from 25 to 13, 24 to 10 and 27 to 15 among the three groups respectively. Dysfunctional voiding symptom score was significantly reduced from 20 to 10, 22 to 13 and 25 to 16 among the three groups respectively.
Compete resolution of daytime incontinence occurred in 48%, 58.3% and 44% of the TENS, Solifenacin and refractory groups respectively. While nocturnal enuresis resolved in 68%, 73% and 64% for the three groups respectively.