Transcutaneous Electrical Nerve Stimulation in Children With Overactive Bladder: A Randomized Clinical Trial

Lordêlo, Patrícia; Teles, Alcina; Veiga, M.L.; Correia, Luís Cláudio Lemos; Barroso, Ubirajara

doi:10.1016/j.juro.2010.03.053

Cited by 94 publications

(109 citation statements)

References 25 publications

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“…Earlier uncontrolled studied reported improvement and cure rates of OAB or lower urinary tract dysfunction from 56-100%. 64,65 Two sham-controlled studies showed similar results, 66,67 as has a 2015 uncontrolled study reporting complete and partial response rates of 70 and 22%, respectively. 68 Recently, two groups compared TENS to approved treatment options for OAB in children.…”

Section: Neuromodulationmentioning

confidence: 75%

Overactive bladder in children

Ramsay¹,

Bolduc²

2017

CUAJ

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Overactive bladder (OAB) is a highly prevalent disorder in the pediatric population. This condition is especially troublesome for pediatric patients and their families when associated with incontinence, since it negatively affects self-esteem and impairs children's development. From the patient's perspective, urgency and urge incontinence can have a significant impact, negatively affecting their quality of life. For a therapy to have true benefit, changes must not only be statistically significant, but must also be perceived as meaningful by the patient. A stepwise approach is favoured to treat this pathology, starting with behavioural therapy, followed by medical management, and eventually more invasive procedures.Antimuscarinic agents are the mainstay of medical treatment for OAB. Oxybutynin is the most commonly used antimuscarinic in the pediatric population. However, some patients have a suboptimal response to antimuscarinics and many experience bothersome side effects, which have been documented with all antimuscarinics to a significantly higher degree than placebo. Although there have been reports about the use of tolterodine, fesoterodine, trospium, propiverine, and solifenacin in children, to date, only oxybutynin has been officially approved for pediatric use by medical authorities in North America. This review will address alternative treatment options for pediatric patients presenting with OAB, from conservative measures to more invasive therapies.

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Section: Neuromodulationmentioning

confidence: 75%

Overactive bladder in children

Ramsay¹,

Bolduc²

2017

CUAJ

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“…L'exploration urodynamique, même si elle est bien codifiée, reste un examen invasif, notamment chez l'enfant. D'ailleurs, dans la littérature, l'évaluation thérapeutique dans les études pédiatriques était le plus souvent clinique (évaluation des symptômes ressentis, catalogue mictionnel) [7][8][9][10][11][12][13]16]. Seule l'étude de De Gennaro et al portant sur la stimulation percutanée du nerf tibial [12] complétait l'analyse clinique avec une exploration urodynamique, qui mettait en évidence chez les patients répondeurs une normalisation de la capacité cystomanométrique dans 62,5 % des cas, avec une disparition de l'hyperactivité détru-sorienne.…”

Section: Discussionunclassified

“…Deux séries pédiatriques étaient des essais randomisés sur des patients souffrant d'hyperactivité vésicale. L'étude brésilienne de Lordelo et al [16] éva-luait l'efficacité de la stimulation transcutanée parasacrale chez 21 patients versus 16 patients dans le groupe témoin (4 électrodes dans les 2 groupes : 2 électrodes parasacrales et 2 électrodes scapulaires). Le taux de succès dans le groupe effectivement traité était de 61,9 % contre 0 % dans le groupe témoin.…”

Section: Discussionunclassified

“…D'ailleurs, dans sa revue de la littérature, Barroso et al suggèrent que compte tenu des effets secondaires des antimuscariniques et de l'innocuité de l'électrostimulation transcutanée parasacrale, l'électrostimulation pourrait être envisagée en traitement de première intention [20]. Cette équipe brésilienne a d'ailleurs publié une étude prospective récente portant sur la stimulation transcutanée parasacrale en première intention chez des patients souffrant d'hyperactivité vésicale avec un taux de succès de 61,9 % [16]. Il pourrait en être de même pour l'électrostimulation transcutanée tibiale postérieure, mais d'autres études sont nécessaires pour en élargir les indications.…”

Section: Discussionunclassified

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Stimulation transcutanée du nerf tibial dans le traitement des hyperactivités vésicales réfractaires de l’enfant et de l’adolescent

Bouali

Even

Mouttalib

et al. 2015

Progrès en Urologie

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“…Based on the results, IF-ES may be an applicable salvage modality, although the efficacy should be investigated in detail, especially in comparison with conventional methods such as TENS. For neurologically normal patients who do not response to pharmacotherapy for behavior therapy, TENS has been reported to be effective [18], and we expect that IF-ES will also be effective but with fewer adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Salvage Interferential Electrical Stimulation Therapy in Patients With Medication-Refractory Enuresis: A Pilot Study

Lee

Park

2013

Int Neurourol J

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PurposeIn pediatric patients with enuresis, the protocol for salvage therapy in patients in whom first-line therapy was not successful has not yet been established. Interferential electrical stimulation (IF-ES) therapy is advantageous because it is noninvasive and shows high compliance. We aimed to investigate the efficacy and safety of IF-ES therapy on pediatric enuresis in a pilot study.MethodsWe investigated 10 patients who underwent IF-ES therapy between August 2012 and March 2013 at our clinic. Patients with a history of previous treatment with desmopressin and anticholinergic agents for at least 3 months and those in whom alarm treatment previously failed or was refused by parents were eligible. Electrical current was given starting at approximately 20 mA and was increased until the patient complained of discomfort. Treatment was performed once a week, 20 minutes per treatment, 6 times per cycle. After each cycle, an interview was performed and voiding diaries were filled. The physician in charge evaluated improvement according to the International Children's Continence Society criteria.ResultsA final analysis was performed in 10 patients (5 male and 5 female patients) in whom therapy for nocturnal enuresis had failed. Eight patients had nonmonosymptomatic enuresis and 2 had monosymptomatic enuresis. The mean age of the patients was 8.5±2.4 years, and the mean number of treatments was 10.6±3.6 times. A full response was observed in 1 patient (10%); a good response, in 1 patient (10%); a partial response, in 7 patients (70%); and no response, in 1 patient (10%).ConclusionsOur study demonstrated that IF-ES therapy can be a promising treatment for the future, is safe, and can benefit from appropriate clinical trials in carefully selected groups. IF-ES therapy is expected to be a safe and effective treatment modality for children with enuresis.

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Transcutaneous Electrical Nerve Stimulation in Children With Overactive Bladder: A Randomized Clinical Trial

Abstract: This is the first known randomized clinical trial to demonstrate that parasacral transcutaneous electrical nerve stimulation is effective in the treatment of children with overactive bladder.

Cited by 94 publications

References 25 publications

Overactive bladder in children

Overactive bladder in children

Stimulation transcutanée du nerf tibial dans le traitement des hyperactivités vésicales réfractaires de l’enfant et de l’adolescent

Efficacy of Salvage Interferential Electrical Stimulation Therapy in Patients With Medication-Refractory Enuresis: A Pilot Study

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