Percutaneous electrical nerve stimulation in children with therapy resistant nonneuropathic bladder sphincter...

Area of Science:

• Pediatric Urology
• Neuromodulation
• Bladder Dysfunction

Background:

• Therapy-resistant nonneuropathic bladder sphincter dysfunction affects many children.
• Conventional urological and pharmacotherapies often fail in these cases.
• Percutaneous electrical nerve stimulation offers a potential alternative treatment modality.

Purpose of the Study:

• To evaluate the efficacy of percutaneous electrical nerve stimulation (PENS) for treating voiding dysfunction in children.
• To assess the impact of PENS on symptoms like urgency, incontinence, and voiding frequency.
• To analyze changes in uroflowmetry and bladder capacity following PENS treatment.

Main Methods:

• A prospective study involving 32 children (17 boys, 15 girls) with a mean age of 11.7 years.
• Children received PENS via tibial nerve stimulation (20 Hz, 30 minutes weekly) after failing other treatments.
• Outcomes were assessed every 6 weeks, measuring urgency, incontinence, voiding frequency, uroflowmetry, and bladder capacity.

Main Results:

• Urgency resolved in 7 children and improved in 10.
• Daytime incontinence resolved in 4 children and decreased in 12.
• Normal voiding frequency (4-6 voids/day) was achieved by 16 of 19 patients.
• Abnormal uroflowmetry normalized in 9 of 21 children.
• Mean bladder capacity significantly increased from 185.16 ml to 279.19 ml.

Conclusions:

• Percutaneous electrical nerve stimulation demonstrates significant effectiveness in managing nonneurogenic bladder sphincter dysfunction in children.
• PENS positively influences key parameters including voiding frequency, uroflowmetry curves, and bladder capacity.
• This neuromodulation technique presents a promising therapeutic option for pediatric voiding dysfunction refractory to conventional treatments.