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Evaluation of constipation after parasacral transcutaneous electrical nerve stimulation in children with lower
Maria Luiza Veiga1, Patrícia Lordêlo, Tiago Farias
1CEDIMI, Center for Childhood Urinary Disorders, Bahiana School of Medicine, Bahia, Brazil.
Insights
Parasacral transcutaneous electrical nerve stimulation (TENS) effectively treated constipation in children with lower urinary tract dysfunction (LUTD). This non-invasive therapy improved constipation symptoms and related urinary issues, offering a promising solution for pediatric patients.
Area of Science:
- Pediatric Urology
- Gastroenterology
- Neuromodulation
Background:
- Constipation is a common issue in children with lower urinary tract dysfunction (LUTD).
- Existing treatments for constipation in this population may have limitations.
Purpose of the Study:
- To evaluate the efficacy of parasacral transcutaneous electrical nerve stimulation (TENS) for treating constipation in children diagnosed with LUTD.
Main Methods:
- A cohort of 14 children (9 boys, 5 girls) with LUTD and constipation received 20 sessions of parasacral TENS (20 min, 10 Hz, 3 times/week).
- Constipation was assessed using Rome III criteria, Bristol Stool Chart, and a visual analog pain scale.
- No concurrent constipation-specific treatments were administered during the study period.
Main Results:
- 85.7% of children showed improvement in constipation symptoms based on Rome III criteria (p < 0.001).
- Significant improvements were noted in fecal incontinence, stool retention, and rectal fecal mass.
- While Bristol Stool Chart scores did not significantly change (p < 0.25), a trend towards reduced pain was observed (p < 0.063).
- All evaluated urinary symptoms improved, with a decrease in post-void residual urine.
Conclusions:
- Parasacral TENS demonstrates satisfactory efficacy in managing constipation in children with LUTD.
- This study is the first to report positive outcomes of parasacral TENS for constipation in this pediatric group.
- The treatment offers a potential non-invasive therapeutic option for combined constipation and LUTD.
Objective:
To evaluate the efficacy of parasacral transcutaneous electrical nerve stimulation (TENS) for the treatment of constipation in children with lower urinary tract dysfunction (LUTD).
Materials And Methods:
We treated 9 boys and 5 girls with a mean age of 8.07 ± 2.72 years. 10 (71.4%) had overactive bladder and 4 (28.6%) had voiding dysfunction. A total of 20 parasacral TENS sessions, 20 min each (10 Hz), were performed 3 times per week. The criteria used to assess constipation were the Rome III criteria for children, the Bristol Stool Chart, and a visual analog scale (pain from 0 to 10). The children were reassessed immediately after treatment. No specific treatment of constipation was performed.
Results:
After treatment, 85.7% (p < 0.001) of the children's constipation symptoms had improved following the Rome III criteria. Parasacral TENS significantly impacted the following symptoms: "the presence of at least one episode of fecal incontinence per week", "history of stool retention", and "the presence of a large fecal mass in the rectum." There was no significant change in the Bristol Stool Chart evaluation (p < 0.25), but there was a significant improving trend in level of pain before and after treatment (p < 0.063). All urinary symptoms evaluated showed improvement after TENS treatment. There was a decrease in post-void residual urine.
Conclusion:
In this first study to evaluate the results of parasacral TENS on constipation in children with LUTD, satisfactory results were obtained for both complaints.