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Parasacral transcutaneous electrical neural stimulation versus urotherapy in primary monosymptomatic enuresis: A
Liliana Fajardo Oliveira1, Lidyanne Ilidia da Silva2, Hanny Helena Masson Franck2
1School of Physiotherapy-Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ/SUPREMA), Juiz de Fora, Brazil.
Insights
Parasacral transcutaneous electrical neural stimulation (TENS) combined with urotherapy effectively increased dry nights in children with primary monosymptomatic nocturnal enuresis (PMNE). This treatment shows promise for managing bedwetting, though complete symptom resolution was not achieved.
Area of Science:
- Pediatric Urology
- Neuromodulation
- Sleep Medicine
Background:
- Primary monosymptomatic nocturnal enuresis (PMNE) affects many children, impacting their quality of life.
- Current treatments, including urotherapy, have varying success rates.
Purpose of the Study:
- To assess the efficacy of parasacral transcutaneous electrical neural stimulation (TENS) combined with urotherapy for treating PMNE in children.
- To compare this combined approach against urotherapy alone.
Main Methods:
- A prospective controlled clinical trial involving 72 children aged 5+ with PMNE.
- Participants were randomized into two groups: urotherapy with scapular stimulation (control) and urotherapy with parasacral TENS (experimental).
- Both groups received 20 sessions of their respective treatments, with outcomes measured by the percentage of dry nights over 90 days.
Main Results:
- The experimental group (urotherapy + parasacral TENS) showed a higher mean percentage of dry nights compared to the control group at all follow-up points.
- Specifically, the percentage of dry nights in the experimental group increased from 36% at baseline to 57% at 90 days post-treatment.
- The control group showed a smaller increase, from 28% to 36% over the same period.
Conclusions:
- Parasacral TENS combined with urotherapy significantly improves the percentage of dry nights in children with PMNE.
- While effective in increasing dry nights, the combined treatment did not lead to complete resolution of enuresis in any participant.
- Parasacral TENS represents a valuable adjunct to urotherapy for managing pediatric nocturnal enuresis.
Objective:
To evaluate the clinical response of parasacral transcutaneous electrical neural stimulation (parasacral TENS) associated with urotherapy in children with primary monosymptomatic nocturnal enuresis (PMNE) compared to urotherapy alone.
Material And Methods:
This prospective controlled clinical trial enrolled 72 children over 5 years of age with PMNE. Children were randomly divided into two groups, control group (CG), treated with urotherapy and scapular stimulation, and experimental group (EG), treated with urotherapy and parasacral TENS. In both groups, 20 sessions were performed, 3 times weekly, for 20 min each, with 10 Hz frequency, 700 μS pulse width and intesity determinated by the patient threshold. The percentages of dry nights were analyzed for 14 days before treatment (T0), after the 20th session (T1), 15 (T2), 30 (T3), 60 (T4), and 90 (T5) days after the end of the sessions. Patients of both groups were followed with intervals of 2 weeks in the first month and monthly for three consecutive months.
Results:
Twenty-eight enuretic children, 14 girls (50%) with a mean age of 9.09 ± 2.23 years completed the study. There was no difference in mean age between groups. Mean percentage of dry nights in EG at T0 was 36%, at T1 49%, at T2 54%, at T3 54%, at T4 54%, and 57% at T5; while in CG, these percentages were 28%, 39%, 37%, 35%, 36%, and 36%, respectively.
Conclusions:
Parasacral TENS associated with urotherapy improves the percentage of dry nights in children with PMNE, although no patient had complete resolution of symptoms in this study.
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