Electrostimulation in Children With Neurogenic Bladder due to Spina Bifida: Systematic Review and Meta-Analysis

Area of Science:

• Pediatric Urology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Neurogenic bladder in children with spina bifida significantly impacts quality of life.
• Current treatment options for neurogenic bladder have limitations.
• Electrotherapy presents a potential therapeutic modality.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of electrotherapy for neurogenic bladder in pediatric spina bifida patients.
• To evaluate the impact of electrotherapy on bladder compliance, capacity, and lower urinary tract symptoms.

Main Methods:

• Systematic search of multiple databases up to February 2025.
• Inclusion of studies on children (3-21 years) with spina bifida and neurogenic bladder treated with electrotherapy.
• Assessment of methodological quality using standardized tools (PEDro, Cochrane Risk of Bias, ROBINS-I).

Main Results:

• Nine studies with 303 participants were included; four were meta-analyzed.
• Electrotherapy moderately increased bladder compliance and cystometric capacity.
• Detrusor pressure decreased, while detrusor leak point pressure increased; LUTS showed inconsistent improvement.
• Evidence certainty was low to very low due to heterogeneity and limitations.

Conclusions:

• Electrotherapy may improve bladder compliance, capacity, and detrusor pressure in this population.
• Variability in study quality and intervention parameters necessitates caution.
• High-quality research is essential to confirm clinical effectiveness and optimize treatment protocols.