Role of Posterior Tibial Nerve Stimulation in the Treatment of Refractory Monosymptomatic Nocturnal Enuresis: A Pilot Study

Raheem, Ali Abdel; Farahat, Yasser; El‐Gamal, Osama M.; Ragab, Maged; Radwan, Mohamed; Elbahnasy, Abdelhamid M.; El-Gamasy, Abdel Naser; Rasheed, Mohamed

doi:10.1016/j.juro.2012.10.059

Cited by 23 publications

(13 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the basis of the inclusion and exclusion criteria, four RCTs [16][17][18][19] containing 171 children were involved in the article. The details of the four articles are listed in Table 1.…”

Section: Characteristics Of the Trialsmentioning

confidence: 99%

“…Nowadays, some articles have studied the efficacy of ES in treating children with MNE. The effects of ES methods have shown encouraging impacts on normalizing detrusor overactivity, enuresis frequency, and bladder capacity in certain investigations . In contrast, a recent study certificates no antienuretic effect of transcutaneous electrical nerve stimulation in children with MNE .…”

Section: Introductionmentioning

confidence: 99%

“…The effects of ES methods have shown encouraging impacts on normalizing detrusor overactivity, enuresis frequency, and bladder capacity in certain investigations. [15][16][17][18] In contrast, a recent study certificates no antienuretic effect of transcutaneous electrical nerve stimulation in children with MNE. 19 And there has been no systematic review and meta-analysis evaluating the efficacy of ES in treatment of NE in children.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The efficacy of electrical stimulation in treating children with nocturnal enuresis: A systematic review and meta‐analysis

Cui

Yan

et al. 2019

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aim We performed a systematic review and meta‐analysis to evaluate the efficacy of electrical stimulation (ES) in treating children with nocturnal enuresis (NE). Methods Randomized controlled trials (RCTs) of the use of ES for the treatment of NE in children were searched using EMBASE, MEDLINE, and the Cochrane Controlled Trials Register. The references of related articles were also searched. The systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses. Results Four RCTs involving 171 patients were studied. We found that there was statistically significant difference in the wet nights per week (mean difference [MD], −0.70; 95% confidence interval [CI], −0.89 to −0.51; P < .00001), the number of patients with clinical response (MD, 26.88; 95% CI, 11.16 to 64.74; P < .00001), and bladder capacity (MD, −0.70; 95% CI −0.89 to −0.51; P < .00001) in the ES group compared with the placebo group with the exception of maximum voided volume (MVV) (MD, 19.48; 95% CI, −9.18 to 48.14; P = .18). Conclusions The study provides a significant improvement in statistics in the wet nights per week, the number of patients with clinical response and bladder capacity for children with NE compared with the placebo group with the exception of MVV.

show abstract

Section: Characteristics Of the Trialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The efficacy of electrical stimulation in treating children with nocturnal enuresis: A systematic review and meta‐analysis

Cui

Yan

et al. 2019

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…Alarm therapy was effective for cases refractory to pharmacotherapy, and nonresponders to alarm therapy were also refractory to pharmacotherapy 57. In patients with refractory MNE, a combined approach may improve enuresis,58–60 and methods such as posterior tibial nerve stimulation,61 interferential electrical stimulation therapy,62 acupuncture treatment,63 abdominal and pelvic floor muscle retraining,64 and assumption of unusual posture during sleep, in particular legs retracting or crossing during sleep to enlarge the diaphragmatic excursion and promote alveolar gas exchanges,65 have been tried in refractory primary MNE. The identification of SDB may open new therapeutic pathways, in terms of surgery for the upper obstructed airway for those patients with NE who do not respond to standard treatment 66…”

Section: Discussionmentioning

confidence: 99%

Sleep apnea in children with refractory monosymptomatic nocturnal enuresis

El‐Mitwalli¹,

Bediwy²,

Zaher³

et al. 2014

NSS

View full text Add to dashboard Cite

BackgroundChildren with nocturnal enuresis (NE) are believed to have deep sleep with high arousal threshold. Studies suggest that obstructive sleep apnea–hypopnea syndrome (OSAHS) and NE are common problems during childhood. We sought to assess the prevalence of OSAHS in children with refractory NE and whether its severity is associated with the frequency of bedwetting.MethodsThe study group comprised 43 children with refractory monosymptomatic NE and a control group of 30 children, both aged 6–12 years. All subjects underwent thorough neurological examination, one night of polysomnography only for the patient group, and a lumbosacral plain X-ray to exclude spina bifida.ResultsThe groups were well matched. Two subjects of the control group had mild OSAHS. The mean age of the patients was (9.19±2.4 years), 26 were boys, and 67% showed frequent NE (>3 days bedwetting/week). Patients with NE had significantly higher rates of OSAHS (P<0.0001); three patients had mild, 12 had moderate, and eleven showed severe OSAHS. There was no significant statistical difference among patients having OSAHS in relation to age, sex, or family history of NE. The frequency of bedwetting was statistically significantly higher in patients with severe OSAHS (P=0.003).ConclusionPatients with refractory NE had a significantly higher prevalence of OSAHS with no sex difference. The frequency of bedwetting was higher in patients with severe OSAHS.

show abstract

“…Another possible etiology of MNE is nocturnal polyuria with decreased arousal from full bladder during sleep due to brainstem enuresis inhibiting reflex maturational delay. Psychological factors are also possible causes which if not properly treated results in resistance of many cases to treatments (Baeyens et al 2007;Raheem et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Primary monosymptomatic nocturnal enuresis: an etiological study

Bahnasy

El-Heneedy

El-Seidy

et al. 2018

Egypt J Neurol Psychiatry Neurosurg

View full text Add to dashboard Cite

Background: Nocturnal enuresis (NE) is a very common chronic pediatric problem with bad psychological consequences. Methods: Forty primary monosymptomatic nocturnal enuresis (MNE) children and 20 healthy controls were recruited in the study and subjected to history taking, neurological and urological examinations, and psychological assessment using the Arabic-translated and validated version of child behavior checklist, sleep architecture studying through onenight polysomnography (PSG), and vasopressin levels determination both diurnal and nocturnal. Results: Enuretic children had positive family history of NE in 42.5%, inverted vasopressin circadian rhythm in 52.5% and PSG changes in the form of increased N3 deep sleep % of total sleep time (TST), sleep stage transition index (SSTI), periodic limb movement index (PLMI), and snore index. Enuretic children PSG showed decreased deep sleep latency, N1% of TST, N2% of TST, and REM % of TST. The child behavior checklist showed higher anxious depressed symptoms, social problem, attention problems, and internalizing problems in enuretic children than control subjects. Conclusions: MNE is a heterogeneous disorder with multiple factors interplay in its pathogenesis. So, the management must be tailored patient by patient according to the dominating etiology.

show abstract

Role of Posterior Tibial Nerve Stimulation in the Treatment of Refractory Monosymptomatic Nocturnal Enuresis: A Pilot Study

Abstract: Posterior tibial nerve stimulation can be a viable treatment option in some patients with refractory monosymptomatic nocturnal enuresis. However, deterioration in some responders with time suggests the need for maintenance protocols.

Cited by 23 publications

References 25 publications

The efficacy of electrical stimulation in treating children with nocturnal enuresis: A systematic review and meta‐analysis

The efficacy of electrical stimulation in treating children with nocturnal enuresis: A systematic review and meta‐analysis

Sleep apnea in children with refractory monosymptomatic nocturnal enuresis

Primary monosymptomatic nocturnal enuresis: an etiological study

Contact Info

Product

Resources

About