Sacral Transcutaneous Electrical Nerve Stimulation Versus Oxybutynin in Children With Overactive Bladder: A Prospective Randomized Controlled Trial
In brief
Sacral TENS achieves complete response in 68% of kids vs 32% with oxybutynin
In a randomized trial of 82 children with refractory overactive bladder, daily sacral TENS for four weeks produced a complete response in about two-thirds of patients, more than double the rate seen with standard oxybutynin. TENS also improved symptom scores, caused far fewer side effects (5% vs 46%) and had lower relapse at one year, suggesting a well-tolerated alternative that merits larger studies.
- Journal
- Neurourology and urodynamics (Q1)
- Published
- 21 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Sathyamurthy Arunaa, Ramesh Babu, Ramasundaram Madhu, Sambandan Kumaravel
- PMID
- 42765542
- DOI
- 10.1002/nau.70451
Why clinicians should know about it
- Picked for Urology (paper of the day, 24 September 2026): Sacral TENS vs oxybutynin in pediatric OAB
Abstract
AIMS: The aim of this RCT is to compare the efficacy of sacral transcutaneous electrical nerve stimulation (TENS) with oxybutynin in children with overactive bladder (OAB), focusing on subjective & objective treatment response, adverse effects, and relapse rates. MATERIALS AND METHODS: In this prospective randomized controlled study, 82 children aged 5-18 years with refractory OAB were randomized to receive either sacral TENS (30 sessions; 20 min each (10 Hz) daily; for 4 weeks) or oral oxybutynin (0.2 mg/kg/day for 4 weeks). Outcomes were assessed using subjective response categories based on bladder diaries and objective measures including the Overactive Bladder Index (OABI) and Dysfunctional Voiding Symptom Score (DVSS). Adverse effects and relapse during 6-12 months of follow-up were recorded. RESULTS: There was no significant difference between age/sex distributions between the groups. Median follow-up was 9 (6-12) months. Complete response was significantly higher with TENS than oxybutynin (68.3% vs. 31.7%; OR 4.63, 95% CI 1.8-11.7; p = 0.001). Mean improvement in OABI (4.6 ± 1.4 vs. 3.7 ± 1.0; p = 0.001) and DVSS (8.8 ± 1.5 vs. 5.7 ± 1.3; p = 0.001) favored TENS. Adverse effects (4.9% vs. 46.3%) and relapse rates (7.3% vs. 29.3%) were significantly lower with TENS. CONCLUSION: Sacral TENS was associated with higher response rates and fewer adverse effects than oxybutynin in this cohort supporting its role as an effective and well-tolerated therapeutic option for pediatric OAB. Further larger trials are warranted.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.