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Effectiveness of a Practical, At-Home Regimen of Parasacral Transcutaneous Electrical Nerve Stimulation in Pediatric
Kristin M Ebert1, Heather Terry1, Christina B Ching1
1Division of Urology, Nationwide Children's Hospital, Columbus, OH.
Insights
An at-home parasacral transcutaneous electrical nerve stimulation (TENS) regimen showed promise for pediatric overactive bladder (OAB), with nearly half of patients reporting subjective improvement. Compliance was high, suggesting practicality as an adjunctive therapy.
Area of Science:
- Urology
- Pediatric Urology
- Neuromodulation
Background:
- Pediatric overactive bladder (OAB) presents a significant challenge in clinical practice.
- Current treatment options may have limitations or side effects.
- Exploring practical, at-home therapeutic modalities is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and practicality of an at-home parasacral transcutaneous electrical nerve stimulation (TENS) regimen for children with OAB.
- To assess patient-reported outcomes and objective measures following the TENS intervention.
Main Methods:
- A prospective study enrolled 21 pediatric patients (ages 5-13) with OAB.
- Participants underwent a 1-month at-home TENS regimen (20-minute sessions, twice daily).
- Efficacy was assessed using the Vancouver Symptom Score (VSS) and frequency-volume charts, with compliance monitored via daily logs.
Main Results:
- High compliance (median 98%) was observed for the at-home TENS regimen.
- 8 out of 17 patients reported subjective improvement in OAB symptoms.
- A statistically significant reduction in VSS scores was noted (median 23 to 21, P=.009), though secondary outcome measures showed no significant changes.
Conclusions:
- The at-home parasacral TENS regimen appears practical for pediatric OAB patients, demonstrating high adherence.
- Nearly half of the participants reported subjective symptom improvement.
- While objective measures showed limited change, TENS may serve as a valuable adjunct to other OAB therapies.
Objective:
To describe and evaluate efficacy of a more practical, at-home regimen of parasacral transcutaneous electrical nerve stimulation (TENS) for pediatric overactive bladder (OAB).
Methods:
We prospectively enrolled patients with OAB.
Inclusion Criteria:
age 5-13 years and willingness to try TENS.
Exclusion Criteria:
urinary tract anatomic abnormalities, current use of OAB medications, neurologic condition, and elevated post-void residual. Patients were instructed to complete 20-minute sessions 2x/day for 1 month. Patients completed the Vancouver Symptom Score (VSS) and 48-hour frequency-volume chart before/after treatment. Compliance was assessed with a daily log. We recorded patient-reported improvement. Primary outcome was difference in VSS before/after treatment; secondary outcomes included: differences in frequency of voids/24 hours, max voided volume in 48 hours (%EBC), mean voided volume (%EBC), and mean number incontinence episodes/24 hours.
Results:
We enrolled 21 patients (3 male, 18 female; median age 9.9 years). We had complete VSS data on 17 patients and frequency-volume chart data on 12 patients. Median % of TENS sessions completed was 98%. 8/17 patients reported subjective improvement. There was a significant difference between pre- and post-TENS VSS (median score: 23 pre-TENS and 21 post-TENS, P = .009). There were no differences in secondary outcomes before/after treatment.
Conclusion:
In our cohort of medically-refractory OAB pediatric patients, nearly half reported subjective improvement with our regimen, despite modest objective improvement. Our compliance rates suggest this regimen is practical but may be best used as an adjunct to other therapies.
