Efficacy of Solifenacin Combined with Biofeedback in Children with Neurogenic Detrusor Overactivity Caused by Primary Tethered Cord Syndrome

Abstract

Purpose

Neurogenic detrusor overactivity (NDO) can lead to elevated bladder pressure and pose significant risks to the upper urinary tract. This study aimed to evaluate the efficacy of combining solifenacin with biofeedback in treating pediatric NDO caused by primary tethered cord syndrome (TCS).

Methods

This study conducted a retrospective analysis of 32 children diagnosed with NDO caused by primary TCS, who were enrolled and assigned to two groups: group A (n = 16) received solifenacin alone, whereas group B (n = 16) underwent a combined regimen of solifenacin and biofeedback. Outcomes, including lower urinary tract symptoms, urodynamic parameters, and post-void residual urine (PVRU), were assessed at 4, 12, and 24 weeks.

Results

At 4 and 12 weeks after the initial treatment, both groups showed improvement in lower urinary tract symptoms compared with baseline. However, no statistically significant differences were observed in both groups (P > .05). In assessments at 24 weeks, group B exhibited greater improvement in lower urinary tract symptoms and urodynamic parameters compared with group A (P < .05). These differences were particularly evident in bladder compliance and detrusor overactivity. Despite these superior outcomes, group B required lower cumulative doses of solifenacin than group A. Additionally, no statistically significant improvements were found in PVRU or detrusor function during voiding in either group throughout the follow-up period.

Conclusions

The combination of solifenacin and biofeedback proved to be an effective treatment for pediatric NDO caused by primary TCS, compared with solifenacin monotherapy. This combined approach not only enhanced clinical outcomes but also allowed for reduced solifenacin dosages.