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Extracorporeal magnetic innervation therapy in children with refractory monosymptomatic nocturnal enuresis
Seok Ho Kang1, Jae Hyun Bae, Kang Soo Shim
1Department of Urology, Korea University Hospital, Seoul, Republic of Korea.
Insights
Extracorporeal magnetic innervation (ExMI) therapy shows promise for treating refractory monosymptomatic nocturnal enuresis in children. This novel treatment increased functional bladder capacity and reduced bedwetting frequency in a pilot study.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Child Health
Background:
- Monosymptomatic nocturnal enuresis (MNE) is common in children.
- Refractory MNE often requires alternative treatment approaches.
- Reduced functional bladder capacity is a potential cause of refractory MNE.
Purpose of the Study:
- To assess the efficacy of extracorporeal magnetic innervation (ExMI) therapy.
- To evaluate ExMI for children with MNE unresponsive to standard treatments.
- To investigate the impact of ExMI on functional bladder capacity.
Main Methods:
- Prospective study of 55 children with refractory MNE.
- ExMI therapy administered weekly for at least 4 weeks.
- Voiding diaries used to track enuresis frequency and bladder capacity.
Main Results:
- Significant reduction in nocturnal enuresis frequency (P=0.04).
- Mean functional bladder capacity increased 1.88-fold (P=0.00).
- 63.6% of patients achieved >50% reduction in enuresis frequency.
Conclusions:
- Reduced functional bladder capacity may underlie refractory MNE.
- ExMI therapy demonstrates an acute effect by increasing bladder capacity.
- Further research with long-term follow-up and sham-controlled trials is needed.
Objectives:
To evaluate the effect of extracorporeal magnetic innervation (ExMI) therapy in children with refractory monosymptomatic nocturnal enuresis (MNE).
Methods:
A total of 55 children (34 boys and 21 girls, median age 8.0 years, range 5 to 13) who wetted the bed more than twice per week because of MNE that was refractory to treatment with desmopressin, anticholinergics, and enuretic alarm were assessed prospectively using a voiding diary before and after ExMI, administered once a week for at least 4 weeks with a size-adjusted magnetic chair (each session lasted 20 minutes).
Results:
After all sessions of ExMI, the mean frequency of nocturnal enuresis decreased significantly to 2.09 +/- 2.47 in all patients (P = 0.04), and the mean functional bladder capacity increased 1.88 times in all patients (P = 0.00). In total, 63.6% of our patients had a nocturnal enuresis frequency of less than 50% after a mean of 6.62 +/- 4.26 ExMI sessions.
Conclusions:
From our results, reduced functional bladder capacity might be the main pathophysiologic cause in children with MNE refractory to established treatment. ExMI might have an acute inhibitory effect in these children with refractory MNE by increasing functional bladder capacity. However, long-term follow-up data and controlled study with a sham-stimulation group are necessary to determine the durability of this new therapy for refractory MNE.
