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Functional Magnetic Stimulation in the Management of Lower Urinary Tract Dysfunction in Children with Asperger
Edva Anna Frunda1, Orsolya Katalin Ilona Mártha2,3, András Kiss4
1Institution Organizing University Doctoral Studies (I.O.S.U.D.), George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania.
Insights
Children with Asperger syndrome (AS), a form of autism spectrum disorder (ASD), often experience lower urinary tract symptoms (LUTS). Functional magnetic stimulation (FMS) offers a promising non-pharmacological treatment for these conditions, improving bladder function and quality of life.
Area of Science:
- Pediatric Urology
- Neurodevelopmental Disorders
- Autism Spectrum Disorder (ASD)
Background:
- Asperger syndrome (AS), a variant of autism spectrum disorder (ASD), affects 0.02%-0.03% of children globally.
- Children with AS exhibit communication challenges, stereotyped behaviors, and a higher prevalence of micturition disorders and lower urinary tract symptoms (LUTS) compared to neurotypical children.
- Co-occurring conditions like chronic constipation and bladder dysfunction are common in children with AS.
Abstract:
Background/Objectives: A variant of autism spectrum disorder (ASD) known as Asperger syndrome (AS) shows increasing incidence worldwide, affecting between 0.02% and 0.03% of children. Patients display abnormal conduct, are limited in social interaction and communication, and are more often affected by micturition disorders, incontinence, and voiding symptoms than typically developing children. Methods: The present study aimed to review the literature related to the current management of lower urinary tract conditions in children with Asperger syndrome and to present a case of a 14-year-old girl with ASD, with characteristic impairments, including communication challenges, stereotyped, repetitive behaviors, and chronic constipation with concomitant bladder dysfunction, presenting recurrent urinary tract infections (UTIs) and lower urinary tract symptoms (LUTS), including voiding and filling storage symptoms. For the AS, she was treated with a selective serotonin reuptake inhibitor (Sertraline). An abdominal ultrasound, PLUTTS-pediatric lower urinary symptoms scoring (21); QL-quality of life (3); voiding diary; and uroflowmetry were performed, revealing an incomplete urinary retention (incomplete bladder emptying of 120 mL), a prolonged and interrupted curve, a maximum urinary flow rate (Qmax) 7 mL/s, and a UTI with Enterococcus. Results: Besides psychiatric reevaluation and antibiotic therapy, functional magnetic stimulation (FMS) sessions were performed. After eight sessions (20 min, 35 MHz, every second day), the ultrasound control and the uroflowmetry showed no residual urine, and the Qmax was 17 mL/s. The curve continued to be interrupted: PLUTSS-11, QL-1. FMS was continued at two sessions per week. At the 3-month follow-up, no residual urine was detected, and Qmax reached 24 mL/s. Conclusions: ASD is an incapacitating/debilitating condition that significantly impairs social functioning. In many cases, in addition to psychological symptoms, other conditions such as LUTS and constipation may coexist. Antipsychotics and antidepressants are frequently prescribed for these patients, often leading to various side effects, including micturition disorders. Therefore, screening for LUTS is recommended, and, if indicated, treatment-especially non-pharmacological and non-invasive approaches, such as FMS-should be considered.
