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Prospective study of transcutaneous parasacral electrical stimulation for overactive bladder in children: long-term
Patrícia Lordêlo1, Paulo Vitor Lima Soares, Iza Maciel
1Department of Urology, Section of Pediatric Urology, Bahiana School of Medicine and Public Health, Salvador-Bahia, Brazil.
Insights
Transcutaneous parasacral electrical stimulation (TPES) effectively treats overactive bladder in children, showing sustained success for urgency and incontinence. While well-tolerated, some symptoms may recur in about 10% of patients.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Bladder Dysfunction
Background:
- Overactive bladder (OAB) significantly impacts children's quality of life.
- Current OAB treatments in children have varying efficacy and side effect profiles.
Purpose of the Study:
- To evaluate the long-term effectiveness and tolerability of transcutaneous parasacral electrical stimulation (TPES) for pediatric overactive bladder.
- To determine success rates for urgency, incontinence, and overall symptom resolution.
Main Methods:
- Prospective evaluation of children with OAB symptoms, specific uroflowmetry, and low post-void residual urine.
- TPES administered at 10 Hz for 20-minute sessions, 3 times weekly for up to 20 sessions.
- Initial and long-term (over 6 months) success rates assessed.
Main Results:
- High initial success rates: 79% for urgency, 76% for incontinence, 77% overall.
- Sustained long-term success observed in 74-84% of patients.
- Recurrence of symptoms occurred in 10% of cases; urinary tract infection resolution was high.
Conclusions:
- TPES is a well-tolerated and effective treatment for pediatric overactive bladder.
- Demonstrates both short-term and durable long-term efficacy.
- A small percentage of patients may experience symptom recurrence over time.
Purpose:
We evaluated the long-term success of transcutaneous parasacral electrical stimulation for overactive bladder in children.
Materials And Methods:
We prospectively evaluated children who underwent transcutaneous parasacral electrical stimulation for overactive bladder. All patients had symptoms of overactive bladder, bell curve in uroflowmetry and low post-void residual urine. The procedure was performed using a frequency of 10 Hz for 20-minute sessions 3 times weekly for a maximum of 20 sessions. Initial and long-term (more than 6 months) success rates were evaluated.
Results:
Transcutaneous parasacral electrical stimulation was performed in 36 girls and 13 boys with a mean age of 10.2 years (range 5 to 17). Mean followup was 35.3 months (range 6 to 80). Before treatment urgency, daytime incontinence and urinary tract infection were seen in 100%, 88% and 71% of cases, respectively. Initial success (full response) was demonstrated in 79% of patients for urgency, 76% for incontinence and 77% for all symptoms. Continued success was seen in 84% of patients for urgency, 74% for daytime incontinence and 78% for all symptoms. If the 30 patients with at least 2 years of followup were considered, treatment was successful in 73%. Recurrence of symptoms after a full response was seen in 10% of cases. Two of 33 patients (6%) with urinary tract infection before the procedure still had infection after treatment.
Conclusions:
Transcutaneous parasacral electrical stimulation is well tolerated, and demonstrates short and long-term effectiveness in treating overactive bladder in children. Symptoms eventually will recur in 10% of patients.