Transcutaneous electrical neural stimulation for the treatment of urinary urgency or urge-incontinence in children and adolescents: a Phase II clinica

Alcantara, Amanda Carolina Almeida de; Mello, Maria Júlia Gonçalves de; Silva, Eduardo Just da Costa e; Silva, Bárbara Bernardo Rinaldo da; Neto, José Pacheco Martins Ribeiro

doi:10.5935/0101-2800.20150065

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…It is known that the voiding diary (VD) is extremely valuable to quantify urinary symptoms and evaluate the response to treatments, but it has as disadvantage the total dependence on the information provided by the patient. It also allows the initiation of the patients' re-education, with changes to their perception of life habits 31 .…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that the combination of treatments makes it difficult to measure their effectiveness in isolation. In our study, the patients did not receive behavioral guidance, but the VD was used to measure the urinary symptoms, and the VD is an instrument that favors behavioral reeducation from the perception of one's own life habits 31 .…”

Section: Discussionmentioning

confidence: 99%

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Comparação entre oxibutinina, eletroestimulação do nervo tibial posterior e exercícios perineais no tratamento da síndrome da bexiga hiperativa

et al. 2019

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RESUMO Objetivou-se avaliar a eficácia dos exercícios perineais, da eletroestimulação transcutânea do nervo tibial posterior (ETNTP) e da oxibutinina em mulheres com síndrome da bexiga hiperativa, que é a segunda causa mais comum de incontinência urinária, com sintomas urinários extremamente incômodos que prejudicam a qualidade de vida. Foram randomizadas 65 mulheres, das quais 57 completaram o tratamento. Formaram-se três grupos: o de exercícios perineais, ETNTP e o grupo controle, que utilizou oxibutinina. Os exercícios foram realizados em grupo, nas posições em pé, supino e sentado, duas vezes por semana, com duração de 30 minutos cada sessão, totalizando 12 sessões. Na ETNTP utilizou-se eletrodo transcutâneo posicionado em maléolo medial e outro 10cm acima, com frequência de 10Hz e largura de pulso de 200 microssegundos, por 30 minutos, duas vezes por semana, totalizando 12 sessões. Na medicação as pacientes receberam oxibutinina de 10mg/dia de liberação imediata divididos e duas doses de 5mg/dia, durante 12 semanas consecutivas. Antes e depois dos tratamentos, as pacientes passaram por uma avaliação composta pela análise do diário miccional, avaliação funcional do assoalho pélvico e aplicação de questionário de qualidade de vida OAB-V8. Houve redução da incontinência de urgência em 50%, 70,5% e 41% nos grupos de exercício, ETNTP e oxibutinina, respectivamente, com significância estatística somente da eletroestimulação. As três modalidades de tratamento foram eficazes na melhora da qualidade de vida para a terapêutica em curto prazo, estatisticamente semelhantes entre si.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparação entre oxibutinina, eletroestimulação do nervo tibial posterior e exercícios perineais no tratamento da síndrome da bexiga hiperativa

et al. 2019

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“…Similarly, studies performed on children with non‐NDO did not find significant changes in all urodynamic parameters after a single TENS session, but UDS and symptomatology improved after continuing the sessions of TENS . Studies recommend electrostimulation at 1 to 3 times per week in a way to better control the application parameters and an increased long‐term effect . The effect of functional electrical stimulation for the management of urinary incontinence was also tested in a study conducted in Iran with children with myelomeningocele and confirmed a reduction on maximum bladder pressure, an increase on maximal bladder capacity, and an improvement in urinary incontinence after 6 months of treatment …”

Section: Discussionmentioning

confidence: 94%

“…21 Studies recommend electrostimulation at 1 to 3 times per week in a way to better control the application parameters and an increased long-term effect. 22,23 The effect of functional electrical stimulation for the management of urinary incontinence was also tested in a study conducted in Iran with children with myelomeningocele and confirmed a reduction on maximum bladder pressure, an increase on maximal bladder capacity, and an improvement in urinary incontinence after 6 months of treatment. 24 The modification of the behavior and pattern of the bladder by the application of an electric current in neurologically intact children is already well accepted.…”

Section: Discussionmentioning

confidence: 95%

Immediate effect of transcutaneous electrical nerve stimulation on urodynamic parameters of children with myelomeningocele

Dombek

Monteiro

Fontes

et al. 2019

Neurourology and Urodynamics

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Objective To evaluate the immediate response of electrical stimulation in children with neurogenic bladder (NB) due to myelomeningocele, using the urodynamic study (UDS). Methods This is a nonrandomized intervention study with 26 children with neurogenic overactive bladder and low bladder compliance due to myelomeningocele, aged 5 to 15 years. Each child performed a routine UDS and then a second UDS, during which the electrical stimulation was applied in the parasacral region. The main outcome was the difference in the maximum bladder pressure observed between the two urodynamic studies, analyzed from the paired t test. Results We found that 77% of the patients had a lower maximum bladder pressure in the test with electrostimulation compared with the ones without electrostimulation. On average, the pressure reduction after stimulation was 7.24 cmH2O (95% confidence interval [CI], 0.35‐14.14; P = .04). The reduction was even higher in children under 12 years of age, compared with the children above 12 years (11.29 cmH2O, 95% CI, 3.47‐19.12; P = .01). Conclusion The use of transcutaneous electrical nerve stimulation had a significant immediate effect on reducing the maximum bladder pressure during the urodynamic studies among the tested pediatric patients with NB. The results were more significant among children under 12 years of age.

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“…Another electrotherapy technique used in clinical practice is parasacral transcutaneous electrical stimulation (PTES), which uses a low-frequency current through transcutaneous electrodes in the sacral region (S3), with the aim of promoting an inhibitory reflex for detrusor muscle inhibition [20], and a consequent reduction in urgency. PTES is used in the treatment of voiding disorders in children [21][22][23] and clinical trials have reported positive effects for OAB in children and adolescents [24][25][26]. Sharma et al [27] found a reduction in nocturia, urgency, and urge-incontinence in women with OAB, treated with PTES.…”

Section: Introductionmentioning

confidence: 99%

Different electrode positioning for transcutaneous electrical nerve stimulation in the treatment of urgency in women: a study protocol for a randomized controlled clinical trial

Padilha

Ávila

Seidel

et al. 2020

Trials

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Background: Urgency is a complaint of sudden, compelling desire to pass urine, which is difficult to defer, caused by involuntary contraction of the detrusor muscle during the bladder-filling stage. To enable detrusor inhibition, electrotherapy resources such as transcutaneous tibial nerve stimulation (TTNS) and parasacral transcutaneous electrical stimulation (PTES) have been used. The objective this study is to publish the study protocol that aims to investigate whether urgency decreases after treatment with both of the techniques. Methods: This randomized controlled clinical trial will include 99 women, aged more than 18 years old, with urgency (score ≥ 8 in the Overactive Bladder-Validated 8-Question Awareness Tool [OAB-V8]). Women will be randomly allocated into three groups: TTNS, PTES, and placebo. The following questionnaires will be applied: the Anamnesis Record, the Incontinence Questionnaire Overactive Bladder, the King's Health Questionnaire, the 24-Hour Voiding Diary, and the OAB-V8, at four different time points: at baseline prior to the first session, at the 6th session, the 12th session and at follow-up. The current used for the transcutaneous electrical stimulation will be a symmetrical balanced biphasic pulsed current, for 12 sessions, twice a week, for 20 minutes. Qualitative variables will be displayed as frequency and percentage, quantitative variables as mean and standard deviation. Comparison of urgency severity among groups will be performed with a repeated measures ANOVA, considering the effect of the three groups and the four evaluations, and interactions among them. Discussion: The present study aims to contribute evidence for a more in-depth discussion on electrode positioning for electrostimulation used in urgency treatment. It should be emphasized that, based on the possibility of confirming the hypothesis that urgency will decrease in a similar way after both treatments (TTNS and PTES), the PTES will be used as an option for positioning the electrodes alternatively to the tibial nerve region in special populations, such as amputees or people with severe lower limb sensory impairment.

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Transcutaneous electrical neural stimulation for the treatment of urinary urgency or urge-incontinence in children and adolescents: a Phase II clinica

Abstract: The electro-stimulation carried out during the twice weekly sessions appeared to be effective and urinary incontinence declined in half of the patients from the 12th session onwards. However, there is a need for a study involving a larger number of patients to confirm the results obtained.

Cited by 10 publications

References 17 publications

Comparação entre oxibutinina, eletroestimulação do nervo tibial posterior e exercícios perineais no tratamento da síndrome da bexiga hiperativa

Comparação entre oxibutinina, eletroestimulação do nervo tibial posterior e exercícios perineais no tratamento da síndrome da bexiga hiperativa

Immediate effect of transcutaneous electrical nerve stimulation on urodynamic parameters of children with myelomeningocele

Different electrode positioning for transcutaneous electrical nerve stimulation in the treatment of urgency in women: a study protocol for a randomized controlled clinical trial

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