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Neurostimulation Therapy for Pediatric Primary Enuresis: A Meta-analysis
Michael E Chua1, Nicolas Fernandez1, Jessica M Ming1
1Division of Urology, The Hospital for Sick Children, Toronto, Canada.
Urology
|May 7, 2017
Summary
Neurostimulation therapy effectively treats pediatric primary enuresis (PPE), showing significant improvements in reducing wet nights compared to control groups. This treatment is safe, with no serious adverse effects reported in the analyzed studies.
Area of Science:
- Pediatric Urology
- Neurology
- Clinical Trials
Background:
- Pediatric primary enuresis (PPE) is a common condition affecting children's quality of life.
- Established treatments for PPE have varying success rates and potential side effects.
Purpose of the Study:
- To evaluate the efficacy and safety of neurostimulation for treating pediatric primary enuresis.
- To conduct a meta-analysis of randomized controlled trials (RCTs) comparing neurostimulation with control interventions.
Main Methods:
- Systematic literature search of RCTs with no language restrictions.
- Risk of bias assessment using Cochrane Collaboration recommendations.
- Meta-analysis using Mantel-Haenszel method to pool relative risk (RR) and confidence intervals (CI).
Main Results:
- Neurostimulation significantly improved outcomes for patients with ≥50% wet-night reduction (RR = 2.20, 95% CI 1.66, 2.90).
- Patients receiving neurostimulation showed significantly better outcomes with ≥90% wet-night reduction (RR = 2.79, 95% CI 1.54, 5.06).
- A significant mean difference in weekly wet-night reduction favored neurostimulation (mean difference -1.95, 95% CI -2.84, -1.07), with no serious adverse effects.
Conclusions:
- Neurostimulation therapy demonstrates efficacy and safety in treating pediatric primary enuresis.
- Further head-to-head RCTs are recommended to compare different neurostimulation protocols.
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