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

This systematic review and meta-analysis aimed to evaluate the efficacy of electrotherapy techniques in the treatment of neurogenic bladder in children with spina bifida.

A systematic search was conducted in MEDLINE, EMBASE, Web of Science, PEDro, and Biblioteca Virtual databases for studies published up to February 2025. Eligible studies included children aged 3-21 with neurogenic bladder due to spina bifida who underwent invasive or non-invasive electrotherapy. The outcomes included were bladder compliance, while secondary outcomes assessed cystometric capacity, detrusor pressure, detrusor leak point pressure, and lower urinary tract symptoms. Methodological quality was assessed using the PEDro scale and the Cochrane Risk of Bias Tool for randomized studies, and the ROBINS-I tool for non-randomized studies. This study was prospectively registered in the Prospero database (CRD-42021242845).

9 studies involving 303 participants (180 receiving electrotherapy and 123 controls) were included, of which four were eligible for meta-analysis. Electrotherapy showed a moderate increase in bladder compliance (+2 mL/cmH2O, 95% CI: 0-5) and maximum cystometric capacity (+73 mL, 95% CI: 56-90). Detrusor pressure decreased (-22 cmH2O, 95% CI: 7-38), while detrusor leak point pressure increased (+13 cmH2O, 95% CI: 2-25). Lower urinary tract symptoms showed inconsistent improvements. The certainty of evidence was low to very low for most outcomes due to study heterogeneity and methodological limitations.

Electrotherapy appears to improve bladder compliance, cystometric capacity, and detrusor pressure in children with neurogenic bladder due to spina bifida. However, due to the variability in study quality and intervention parameters, further high-quality research is needed to confirm its clinical efficacy.