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Management of Bladder Bowel Dysfunction in Children by Pelvic Floor Interferential Electrical Stimulation and Muscle
Seyedeh-Sanam Ladi-Seyedian1, Lida Sharifi-Rad2, Abdol-Mohammad Kajbafzadeh1
1Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran (IRI).
Insights
Combined pelvic floor interferential (IF) electrical stimulation and muscle exercises effectively treat pediatric bladder bowel dysfunction (BBD). This approach significantly improved constipation, daytime incontinence, and urinary tract infections in children.
Area of Science:
- Pediatric Urology
- Pelvic Floor Rehabilitation
- Neuromuscular Electrical Stimulation
Background:
- Bladder bowel dysfunction (BBD) significantly impacts children's quality of life.
- Current treatments for pediatric BBD include behavioral therapies and pelvic floor muscle (PFM) exercises.
- The efficacy of combined therapies needs further investigation.
Purpose of the Study:
- To evaluate the effectiveness of combining pelvic floor interferential (IF) electrical stimulation with PFM exercises for treating BBD in children.
- To compare the outcomes of this combined therapy against PFM exercises alone.
Main Methods:
- A randomized controlled study included 34 children diagnosed with BBD.
- Participants were assigned to either IF electrical stimulation plus PFM exercises (Group A) or PFM exercises alone (Group B).
- Evaluations included ultrasounds, uroflowmetry with electromyography (EMG), and voiding/bowel habit diaries, assessed pre-treatment, post-treatment, and at 6-month follow-up.
Main Results:
- Group A showed significantly higher improvement rates in constipation (82% vs. 47%, P=.03) and daytime incontinence (100% vs. 25%, P=.007) compared to Group B.
- Urinary tract infection resolution was also superior in Group A (80% vs. 38.4%, P=.02) at 6 months.
- No significant differences in uroflowmetry measures were observed between groups post-treatment.
Conclusions:
- The combination of IF electrical stimulation and PFM exercises is a safe and effective treatment for pediatric BBD.
- This integrated approach offers superior outcomes for constipation, incontinence, and UTIs compared to PFM exercises alone.
- Further research can explore long-term effects and optimal parameters for IF electrical stimulation in pediatric BBD management.
Objective:
To assess efficacy of combined pelvic floor interferential (IF) electrical stimulation and muscle exercises on bladder bowel dysfunction (BBD) in children.
Materials And Methods:
A total of 34 children with BBD (6 boys, 28 girls; mean age 7.4 ± 2.2) were included in this study. Children were evaluated with kidney and bladder ultrasounds, uroflowmetry + electromyography (EMG), and a complete voiding and bowel habit diary before treatment. Exclusion criteria were neuropathic disease, anatomical defects, and mental retardation. Participants were randomly allocated into 2 treatment groups including group A (n = 17) who underwent IF electrical stimulation in addition to pelvic floor muscle (PFM) exercises and group B (n = 17) who received PFM exercises alone. All children were re-evaluated by kidney and bladder ultrasounds, uroflowmetry + EMG and a voiding and bowel habit diary at the end of treatment sessions and 6 months later.
Results:
Constipation improved in 14 of 17(82%) and 8 of 17(47%) children in group A and B respectively at the end of treatment sessions (P = .03). Daytime incontinence improved in all children in group A and 2 of 8(25%) children in group B after the treatment (P = .007). Urinary tract infection improved in 8 of 10(80%) and 5 of 13(38.4%) children in group A and B respectively, 6 months after the treatment (P = .02). No significant difference was observed in uroflowmetry measures between 2 groups after the treatment.
Conclusion:
Combination of IF electrical stimulation and PFM exercises is an effective and safe modality for treatment of BBD in children.
