The quality of life of children and adolescents performing CIC appears to be affected by the route of catheterization, with a worse performance for those using urethral catheterization.

has yielded little improvement. We intend to determine whether TENS can be effective in patients with NE when applied to various strategic anatomic locations.METHODS: We conducted a prospective, randomized controlled trial for patients with monosymptomatic NE ages 5 to 18 years old. Exclusion criteria were concomitant medical therapy increasing the risk of incontinence, comorbid urologic disorders, or contraindications to TENS. Following one month of urotherapy, patients were randomized into one of 4 arms: parasacral (PS), PT, suprapubic (SP), and sham (shoulder) arms TENS placement. Nightly TENS therapy was performed for 20 minutes for 30 days. Patients were then observed for one month after completing TENS therapy. Monthly PIN-Q questionnaires and voiding diaries were obtained and outcomes analyzed using descriptive statistics and ANOVA analysis.RESULTS: To date, 53 patients (mean age 10.2AE2.5yr) enrolled. Sixteen patients (30%) improved prior to starting TENS and did not proceed, and 4 await randomization. Enrollment is similar among the groups: 9 PS, 8 PT, 8 SP, and 8 in the shoulder (sham) arm. Baseline PIN-Q scores were similar among the groups (p¼0.534). In the first month, the SP arm had significantly fewer wet nights (p ¼ 0.003), which was upheld on multivariate analysis (p ¼ 0.033). Twenty patients completed 1 month of TENS therapy, in which the PT arm had the most improved PIN-Q scores (-4.3AE4.8) and percent of wet nights (-4.2%AE 5.9), although neither achieved significance (p¼0.673 and p¼0.128, respectively). Fourteen patients completed the durability arm of the trial, in which neither number of wet nights nor mean wet scale achieved significance. While all groups experienced drop in PIN-Q score over the course of each month, no one group significantly exceeded improvement seen in other groups at Month 1 (p ¼ 0.446), Month 2 (p ¼ 0.858), or Month 3 (p ¼ 0.737).CONCLUSIONS: PT application of the TENS unit at bedtime may improve the number of wet nights and PIN-Q scores in patients with NE. Further patient acquisition and follow up will be needed to determine the significance and durability of these results.