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Published on: September 13, 2015
Posterior Tibial Nerve Stimulation in Children with Lower Urinary Tract Dysfunction: A Mixed-Methods Analysis of
Liesbeth L De Wall1, Anna P Bekker1, Loes Oomen1
1Division of Pediatric Urology, Radboud University Medical Center, Amalia Children's Hospital, 6525 GA Nijmegen, The Netherlands.
Insights
Posterior tibial nerve stimulation (PTNS) effectively treats pediatric lower urinary tract dysfunction (LUTD), improving urinary symptoms and quality of life. Group PTNS settings also foster valuable peer support for children and parents.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Therapeutic Interventions
Background:
- Posterior tibial nerve stimulation (PTNS) is a treatment for children with therapy-refractory lower urinary tract dysfunction (LUTD).
- Understanding patient and parent experiences is crucial for optimizing treatment.
- Assessing the impact on quality of life (QOL) alongside symptom improvement is important.
Purpose of the Study:
- To evaluate the effectiveness of PTNS in children with refractory LUTD.
- To explore the experiences of children and parents undergoing PTNS treatment.
- To assess the impact of PTNS on QOL and urinary symptoms.
Main Methods:
- Mixed-methods analysis combining retrospective chart review and qualitative interviews.
- Quantitative assessment of voiding parameters and QOL scores pre- and post-PTNS.
- Qualitative exploration through semi-structured interviews analyzed using constant-comparative method.
Main Results:
- 42% of children showed overall LUTD improvement, with 10% achieving complete resolution.
- Significant increases in average and maximum voided volumes were observed.
- QOL improved for both children and parents, irrespective of symptom improvement; PTNS was well-tolerated.
- Group PTNS settings fostered recognition and peer support.
Conclusions:
- PTNS is an effective treatment for therapy-refractory LUTD in children.
- Group PTNS settings enhance treatment by providing peer support opportunities.
- PTNS offers a valuable therapeutic option for pediatric LUTD with positive QOL impact.
Background:
Posterior tibial nerve stimulation (PTNS) is one of the treatment modalities for children with therapy-refractory lower urinary tract dysfunction (LUTD). This study used a mixed-methods analysis to gain insight into the experiences of children treated with PTNS and their parents, the effect of treatment on quality of life (QOL) and the effect of PTNS on urinary symptoms.
Methods:
Quantitative outcomes were assessed through a single-centre retrospective chart analysis of all children treated with PTNS in a group setting between 2016-2021. Voiding parameters and QOL scores before and after treatment were compared. Qualitative outcomes were assessed by an explorative study involving semi-structured interviews transcribed verbatim and inductively analysed using the constant-comparative method.
Results:
The data of 101 children treated with PTNS were analysed. Overall improvement of LUTD was seen in 42% and complete resolution in 10%. Average and maximum voided volumes significantly increased. QOL improved in both parents and children independent of the actual effect on urinary symptoms. Interviews revealed PTNS to be well-tolerated. Facilitating PTNS in a group setting led to feelings of recognition in both children and parents.
Conclusions:
PTNS is a good treatment in children with therapy-refractory LUTD and provides valuable opportunities for peer support if given in a group setting.
