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Published on: January 10, 2013
Immediate and continued results of parasacral transcutaneous electrical nerve stimulation in paediatric patients with
Michal Maternik1, Agata Lakomy-Gawryszewska1, Katarzyna Józefowicz2
1Department of Paediatrics, Nephrology and Hypertension Medical University of Gdansk, M. Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland.
Insights
Parasacral transcutaneous electrical nerve stimulation (TENS) effectively treats childhood overactive bladder (OAB), significantly reducing incontinence and urgency. Benefits persist for at least six months after the 4-month treatment concludes.
Area of Science:
- Pediatric Urology
- Neurology
- Rehabilitation Medicine
Background:
- Overactive bladder (OAB) is a primary cause of childhood daytime incontinence.
- Parasacral transcutaneous electrical nerve stimulation (TENS) shows promise for pediatric OAB, but lacks standardized protocols.
Purpose of the Study:
- To assess the immediate and sustained efficacy of parasacral TENS as a standalone therapy for children diagnosed with OAB.
Main Methods:
- A prospective study enrolled 57 children (mean age 10.8 years) with OAB.
- Treatment involved 4 months of twice-daily, 1-hour parasacral TENS sessions.
- Outcomes were measured using bladder diaries, 48-hour frequency/volume charts, and uroflowmetry at 2, 4, and 10 months.
Main Results:
- After 4 months, daytime incontinence episodes decreased from 7.23 to 3.94/14 days (p<0.05).
- Nocturnal enuresis dropped from 6.81 to 3.77/14 days (p<0.05), and urgency episodes reduced from 7.36 to 3.58/14 days (p<0.05).
- These improvements remained stable six months post-treatment, with complete remission rates of 32% (daytime incontinence), 35% (nocturnal enuresis), and 50% (urgency).
Conclusions:
- Parasacral TENS is an effective treatment for pediatric OAB, significantly improving incontinence, enuresis, and urgency.
- A 4-month treatment duration enhances outcomes, with sustained effects observed six months after cessation.
- The study highlights the persistent positive impact of parasacral TENS in children with OAB.
Introduction:
Among the conditions underlying childhood daytime incontinence the most frequent is overactive bladder (OAB). Parasacral transcutaneous electrical nerve stimulation (parasacral TENS) is a promising therapy for OAB treatment in children; however, there is no standard treatment protocol.
Objective:
To evaluate the immediate and continued effects of parasacral TENS monotherapy in children with OAB.
Study Design:
57 children at mean age 10.8 years diagnosed with OAB at a single centre were prospectively enrolled from 2013 to 2018. The inclusion criterion was typical OAB symptoms. The treatment results were evaluated based on objective measurements from bladder diaries, 48 h frequency/volume (48 h F/V) charts, and uroflowmetry. The parasacral TENS treatment lasted for 4 months, twice daily, with 1 h sessions. Results were evaluated at three time points: 2 months of therapy, 4 months (end of active therapy), and 10 months (6 months after cessation of therapy).
Results:
After 4 months of parasacral TENS treatment, the number of days with daytime incontinence decreased from 7.23 to 3.94/14 days (p < 0.05), nocturnal enuresis decreased from 6.81 to 3.77/14 days (p < 0.05), and urgency episodes from 7.36 to 3.58 in 14 days (p < 0.05). Treatment effects remained stable 6 months after therapy cessation regarding days with daytime incontinence (from 3.94 [immediately after treatment] to 3.28 in 14 days [6 months after treatment cessation]), nocturnal enuresis (from 3.77 to 2.91 in 14 days), and urgency episodes (from 3.58 to 2.12 in 14 days) (p < 0.05). Complete response after 6 months of therapy was observed in 32% of patients with daytime incontinence, 35% with nocturnal enuresis, and 50% with urgency episodes.
Discussion:
A recent systematic review of parasacral TENS in children with OAB included only two studies with a follow up of 6 months or longer after treatment cessation; therefore, little is known about the continued effects of parasacral TENS. High rates of complete symptom remission were reported in studies where only subjective symptoms were evaluated. Results of our study reveal that the positive effect of treatment persist. The strengths of the present study include its prospective design, large sample size, and uniform standard urotherapy performed prior to TENS.
Conclusions:
The use of parasacral TENS in children with OAB is effective and results in a significant reduction in daytime incontinence, nocturnal enuresis, and urgency episodes. A longer treatment duration of 4 months leads to more improvement and the effects remain stable 6 months after treatment cessation.
