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Transcutaneous interferential electrical stimulation for the management of non-neuropathic underactive bladder in
Abdol-Mohammad Kajbafzadeh1, Lida Sharifi-Rad2, Seyedeh-Sanam Ladi-Seyedian1
1Department of Pediatric Urology, Pediatric Urology Research Center, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Transcutaneous interferential electrical stimulation (IFES) combined with urotherapy effectively manages pediatric underactive bladder (UAB). This treatment improved voiding frequency, bladder capacity, and reduced nighttime wetting in children with UAB.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Voiding Dysfunction
Background:
- Underactive bladder (UAB) in children presents challenges in managing voiding dysfunction.
- Standard urotherapy is a common treatment but may not be sufficient for all cases.
Purpose of the Study:
- To evaluate the efficacy of transcutaneous interferential electrical stimulation (IFES) when combined with standard urotherapy for non-neuropathic UAB in children.
- To compare the outcomes of IFES plus urotherapy against urotherapy alone.
Main Methods:
- A randomized controlled trial involving 36 children diagnosed with non-neuropathic UAB.
- Participants were assigned to either IFES plus urotherapy or urotherapy alone, with 15 sessions administered twice weekly.
- Outcome measures included voiding diaries, bladder ultrasound, and uroflowmetry/electromyography assessed pre-treatment, post-treatment, and at 1-year follow-up.
Main Results:
- The IFES group showed a significant increase in daily voiding episodes compared to the control group (6.3 vs 4.7 times/day).
- Bladder capacity significantly decreased at 1-year follow-up in the IFES group (227 mL) versus controls (344 mL).
- Maximum urine flow rate improved, voiding time decreased, and 77% of IFES patients normalized flow curves, with significant improvement in nighttime wetting.
Conclusions:
- Combining IFES with urotherapy is a safe and effective therapeutic approach for managing pediatric UAB.
- This combined therapy offers significant improvements in urodynamic parameters and clinical symptoms for children with voiding dysfunction.
Objectives:
To assess the efficacy of transcutaneous interferential electrical stimulation (IFES) and urotherapy in the management of non-neuropathic underactive bladder (UAB) in children with voiding dysfunction.
Patients And Methods:
In all, 36 children with UAB without neuropathic disease [15 boys, 21 girls; mean (sd) age 8.9 (2.6) years] were enrolled and then randomly allocated to two equal treatment groups comprising IFES and control groups. The control group underwent only standard urotherapy comprising diet, hydration, scheduled voiding, toilet training, and pelvic floor and abdominal muscles relaxation. Children in the IFES group likewise underwent standard urotherapy and also received IFES. Children in both groups underwent a 15-session treatment programme twice a week. A complete voiding and bowel habit diary was completed by parents before, after treatment, and 1 year later. Bladder ultrasound and uroflowmetry/electromyography were performed before, at the end of treatment course, and at the 1-year follow-up.
Results:
The mean (sd) number of voiding episodes before treatment was 2.6 (1) and 2.7 (0.76) times/day in the IFES and control groups, respectively, which significantly increased after IFES therapy in IFES group, compared with only standard urotherapy in the control group [6.3 (1.4) vs 4.7 (1.3) times/day, P < 0.002). The mean (sd) bladder capacity before treatment was 424 (123) and 463 (121) mL in the control and IFES groups, respectively, which decreased significantly at 1 year after treatment in the IFES group compared with the controls, at 227 (86) vs 344 (127) mL (P < 0.01). Maximum urine flow increased and voiding time decreased significantly in the IFES group compared with controls at the end of treatment sessions and 1 year later (P < 0.05). All the children had abnormal flow curves at the beginning of the study. The flow curve became normal in 14/18 (77%) of the children in the IFES group and six of 18 (33%) in the control group by the end of follow-up (P < 0.007). At the end of the treatment course, night-time wetting was improved in all children who had this symptom before the treatment in the IFES group (P < 0.01).
Conclusion:
Combining IFES and urotherapy is a safe and effective therapy in the management of children with UAB.
