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Published on: April 17, 2019
Extracorporeal pelvic floor magnetic stimulation in children with voiding dysfunction
Jae Wook Kim1, Myoung Jin Kim, Ji Yeun Noh
1Brain Korea 21 Project for Medical Science, Urological Science Institute, Yonsei University College Of Medicine, Seoul, Korea.
Insights
Extracorporeal pelvic floor magnetic stimulation improved overactive bladder symptoms in children, reducing voiding frequency and urge incontinence. Further research is needed to establish its role as a primary treatment.
Area of Science:
- Pediatric Urology
- Neurology
- Pelvic Floor Rehabilitation
Background:
- Overactive bladder (OAB) is common in children, leading to urge incontinence (UI) and urgency-frequency syndrome.
- Current treatments for pediatric OAB have limitations, and non-invasive options are sought.
- Extracorporeal pelvic floor magnetic stimulation (EPFMS) shows promise for adult voiding dysfunction, but pediatric data is limited.
Purpose of the Study:
- To evaluate the efficacy of EPFMS in treating pediatric overactive bladder.
- To assess the impact of EPFMS on urge incontinence and urgency-frequency syndrome in children.
Main Methods:
- A prospective study involving 42 children diagnosed with OAB.
- Children were categorized into UI only, monosymptomatic nocturnal enuresis (MNE), or non-monosymptomatic nocturnal enuresis (nMNE) groups.
- EPFMS was administered twice weekly for 4 weeks, with clinical variables tracked via voiding diaries.
Main Results:
- Significant reductions in voiding frequency and UI frequency were observed in the UI only and nMNE groups.
- The MNE group also showed a significant decrease in voiding frequency.
- Functional bladder capacity increased significantly across all groups, though nocturnal enuresis frequency did not change significantly.
Conclusions:
- EPFMS demonstrates an acute positive effect on pediatric overactive bladder symptoms, particularly urge syndrome.
- Further controlled studies with sham groups and varied stimulation durations are required.
- EPFMS may be a viable treatment option for pediatric voiding dysfunction.
Objective:
To determine the effect of extracorporeal pelvic floor magnetic stimulation in children with an overactive bladder, as although such stimulation is an effective treatment for voiding dysfunction such as urge incontinence (UI) and urgency-frequency syndrome, experience in children is scarce.
Patients And Methods:
This prospective study included 42 children diagnosed with an overactive bladder, based on urodynamic or video-urodynamic study; a complete follow-up was available in 34. The children were grouped into those with UI only, not monosymptomatic nocturnal enuresis (nMNE), or MNE, according to their symptoms. Clinical variables were assessed by recording a voiding and nocturnal enuresis diary before and after magnetic stimulation, the latter being administered twice a week for 4 weeks using a size-adjusted magnetic chair (each session took 20 min).
Results:
The UI only and nMNE group had a significant decrease in voiding frequency and frequency of UI (P < 0.05); the MNE group also had a significant decrease in voiding frequency (P < 0.05). There was a significant increase in functional bladder capacity in all groups (P < 0.05) but no significant decrease in the mean volume and frequency of NE in the nMNE and MNE groups (P > 0.05).
Conclusions:
Extracorporeal pelvic floor magnetic stimulation has an acute effect on voiding dysfunction such as urge syndrome in children. However, controlled studies with a sham-stimulation group and various durations of stimulation are necessary for its application as a primary treatment for voiding dysfunction in children.
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