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Anogenital electrical stimulation as treatment of urge incontinence in children
G Gladh1, S Mattsson, S Lindström
1Department of Health and Environment, Division of Paediatrics, Faculty of Health Sciences, Linköping, Sweden. gunilla.gladh@lio.se
Insights
Anogenital afferent stimulation (AGAS) effectively treats therapy-resistant urge incontinence in children. Home-based AGAS complements clinic treatments, improving outcomes for pediatric incontinence.
Area of Science:
- Pediatric Urology
- Neurology
- Rehabilitation Medicine
Background:
- Urge incontinence in children often presents as therapy-resistant.
- Bladder instability is a common diagnosis in pediatric incontinence.
- Anogenital afferent stimulation (AGAS) offers a potential non-invasive treatment modality.
Purpose of the Study:
- To retrospectively evaluate the efficacy of anogenital afferent stimulation (AGAS).
- To assess AGAS in neurologically healthy children with treatment-resistant urge incontinence.
- To determine the impact of home-based AGAS as an adjunct therapy.
Main Methods:
- Retrospective analysis of 48 children (5-14 years) with cystometry-verified bladder instability.
- Application of anogenital afferent stimulations using a dual constant-current stimulator.
- Comparison of pre-treatment and 6-12 month follow-up voiding/incontinence diaries.
Main Results:
- 18 children were cured, and 7 improved (leakage score halved) after AGAS.
- Median 9 clinic sessions and 25 home sessions were administered.
- The treatment was generally well-tolerated by pediatric patients.
Conclusions:
- Anogenital afferent stimulation is an effective treatment for severe pediatric urge incontinence.
- Home-based AGAS is a well-accepted adjuvant therapy, enhancing clinical outcomes.
- AGAS presents a potentially curative option for children with refractory urge incontinence.
Objectives:
To evaluate retrospectively the result of anogenital afferent stimulation (AGAS) in neurological healthy children with therapy-resistant urge incontinence.
Patients And Methods:
The study included 48 children (24 girls and 24 boys, 5-14 years old) with a diagnosis of bladder instability verified by cystometry in all. Anogenital afferent stimulations were applied using a battery-powered dual constant-current stimulator. The children were stimulated continuously at 10 Hz for 20 min once or twice daily and if required the children and/or the parents continued to apply the treatment at home. For home stimulation a single (anal) channel stimulator was used. The patients were instructed to stimulate for 20 min at maximum intensity two to three times a week until the effects were optimal. The outcome was evaluated retrospectively by comparing voiding/incontinence diaries obtained before and at the follow-up 6-12 months after the end of treatment.
Results:
AGAS was applied at the clinic for a median (range) of 9 (4-20) times. Thirty-one children continued with home stimulation for another 25 (5-96) sessions. At the follow-up, 18 children were cured and another seven improved, with a leakage score of less than half that before treatment. The treatment was well tolerated by most children.
Conclusions:
Anogenital afferent stimulation is an effective, potentially curative treatment in children with severe urge incontinence. Home stimulation is a well accepted adjuvant to treatment at the clinic and improves the outcome.
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