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Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a
Abdol-Mohammad Kajbafzadeh1, Lida Sharifi-Rad, Seyedeh Sanam Ladi Seyedian
1Pediatric Urology Research Center and Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, 62 Qarib St, Keshavarz Blvd, 1419733151, Tehran, Iran (IRI), kajbafzd@sina.tums.ac.ir.
Insights
Transcutaneous functional electrical stimulation (FES) effectively treats urinary incontinence in children with myelomeningocele (MMC). This noninvasive therapy improves bladder function and reduces incontinence episodes, offering a safe home-based treatment option.
Area of Science:
- Pediatric Urology
- Neurology
- Rehabilitation Medicine
Background:
- Myelomeningocele (MMC) frequently leads to refractory neuropathic urinary incontinence in children.
- Current treatment options for this condition can be invasive or have limited efficacy.
- There is a need for safe, effective, and accessible treatment modalities for pediatric urinary incontinence associated with MMC.
Purpose of the Study:
- To evaluate the efficacy of transcutaneous functional electrical stimulation (FES) in managing refractory neuropathic urinary incontinence in children with MMC.
- To compare FES treatment with sham stimulation in a pediatric population.
Main Methods:
- A randomized controlled trial involving 30 children with MMC and refractory urinary incontinence.
- Participants were assigned to either FES or sham stimulation groups (15 children each).
- Urodynamic studies (UDS) and daily incontinence assessments were conducted before and after a 6-month treatment period.
Main Results:
- FES significantly increased detrusor leak point pressure (DLPP) from 32 to 55.6 cmH2O (P < 0.03).
- The daily incontinence score significantly improved in the FES group compared to the sham group (P < 0.02).
- No adverse events were reported, indicating a favorable safety profile.
Conclusions:
- Transcutaneous functional electrical stimulation (FES) is a safe, noninvasive, and effective treatment for urinary incontinence in children with myelomeningocele (MMC).
- FES can be utilized as a home-based therapy, improving bladder control and quality of life for affected children.
Purpose:
To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).
Methods:
Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.
Results:
Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0-3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).
Conclusion:
This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.
