Efficacy of transcutaneous functional electrical stimulation on urinary incontinence in myelomeningocele: results of a pilot study

Kajbafzadeh, Abdol‐Mohammad; Sharifi‐Rad, Lida; Dianat, SeyedSaeid

doi:10.1590/s1677-55382010000500012

Cited by 8 publications

(9 citation statements)

References 24 publications

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“…In their study, mean bladder capacity rose from 221 ml pre-treatment to 277 ml [2]. Kajbafzadeh capacity increased in 9 patients [12]. A randomised trial by Laredo et al also demonstrated efficacy of transcutaneous electrical stimulation to the sacral region in the treatment of bladder hyperreactivity in children [13].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of electrical stimulation of the neurogenic bladder: Results of a two-year follow-up study

Radziszewski

2013

NRE

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INTRODUCTION:The complications of neurogenic dysfunction of the urinary bladder still constitute an important cause of death among spinal cord injury patients. AIM OF STUDY: The aim of this study was to assess transcutaneous electrical stimulation of the urinary bladder as a treatment for micturition disorders in patients after spinal cord injury (SCI) over 2 years of follow-up. MATERIAL AND METHODS:The study involved 28 patients (22 men and 6 women) with neurogenic bladder dysfunction following a spinal cord injury. The patients were 16 to 68 years old and 2 to 26 months since their spinal cord injury. The therapeutic programme involved 30 sessions of electrical stimulation of the urinary bladder, five sessions per week. The outcomes of electrical stimulation were assessed by comparing the results of urodynamic examinations performed before treatment, immediately on completion of the treatment and at 24 months post-treatment. RESULTS: Transcutaneous electrical stimulation of the urinary bladder produced a significant increase in bladder capacity (p = 0.001), which was higher by a mean of 117.7 ml immediately on completion of the treatment and a mean of 101.6 ml (p = 0.018) two years after the treatment. The amount of post-void residual urine in the bladder decreased by a mean of 81.9 ml (p = 0.007) immediately after completion of the treatment and a mean of 76.9 ml (p = 0.011) two years after the treatment. Opening pressure was lower by a mean of 3.1 cm H 2 O (p > 0.05) immediately on completion of the electrical stimulation treatment. Intravesical pressure at maximum flow decreased in 19 patients (68%) by a mean of 11.6 cm H 2 O (p > 0.05). At the late follow-up assessment, opening pressure was lower in 17 patients (68%) by a mean of 6.7 cm H 2 O. Two patients demonstrated the micturition phase, which had been absent at baseline and immediately after completion of the treatment. Opening pressure in the entire group was lower compared to baseline by 2.9 cm H 2 O (p > 0.05). Also in the late follow-up assessment, intravesical pressure at maximum flow was reduced in 21 patients (79%) by a mean of 9.6 cm H 2 O (p > 0.05).The maximum voiding velocity increased by a mean of 3.8 ml/s (p = 0.008) immediately after treatment completion and by a mean of 3.6 ml/s (p < 0.001) at two years post-treatment. CONCLUSIONS: Transcutaneous electrical stimulation of the neurogenic bladder in patients following spinal cord injury improves lower urinary tract function. Improved urinary tract function is seen two years following completion of the electrical stimulation treatment.

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Section: Discussionmentioning

confidence: 99%

Outcomes of electrical stimulation of the neurogenic bladder: Results of a two-year follow-up study

Radziszewski

2013

NRE

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“…That 7 patients (70%) showed improvement in daytime urinary incontinence was a promising finding of our study. Considering that the efficacy of IF-ES on pediatric urinary incontinence has already been reported [14], such treatment benefits are attractive merits for patient and parents. An increase in daytime MBC in 3 patients (30%) was also a promising finding.…”

Section: Discussionmentioning

confidence: 99%

“…Although several studies have reported the safety and efficacy of IF-ES for LUTS [6,12,14,22] and enuresis [8,9] in children, IF-ES is not yet practiced in Korea. The reasons appear to be the limited knowledge of the modality, insufficient trained manpower for this outpatient procedure, and cost problems.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Salvage Interferential Electrical Stimulation Therapy in Patients With Medication-Refractory Enuresis: A Pilot Study

Lee

Park

2013

Int Neurourol J

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PurposeIn pediatric patients with enuresis, the protocol for salvage therapy in patients in whom first-line therapy was not successful has not yet been established. Interferential electrical stimulation (IF-ES) therapy is advantageous because it is noninvasive and shows high compliance. We aimed to investigate the efficacy and safety of IF-ES therapy on pediatric enuresis in a pilot study.MethodsWe investigated 10 patients who underwent IF-ES therapy between August 2012 and March 2013 at our clinic. Patients with a history of previous treatment with desmopressin and anticholinergic agents for at least 3 months and those in whom alarm treatment previously failed or was refused by parents were eligible. Electrical current was given starting at approximately 20 mA and was increased until the patient complained of discomfort. Treatment was performed once a week, 20 minutes per treatment, 6 times per cycle. After each cycle, an interview was performed and voiding diaries were filled. The physician in charge evaluated improvement according to the International Children's Continence Society criteria.ResultsA final analysis was performed in 10 patients (5 male and 5 female patients) in whom therapy for nocturnal enuresis had failed. Eight patients had nonmonosymptomatic enuresis and 2 had monosymptomatic enuresis. The mean age of the patients was 8.5±2.4 years, and the mean number of treatments was 10.6±3.6 times. A full response was observed in 1 patient (10%); a good response, in 1 patient (10%); a partial response, in 7 patients (70%); and no response, in 1 patient (10%).ConclusionsOur study demonstrated that IF-ES therapy can be a promising treatment for the future, is safe, and can benefit from appropriate clinical trials in carefully selected groups. IF-ES therapy is expected to be a safe and effective treatment modality for children with enuresis.

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“…The reuseable nature of the generator makes it cost effective over the long term as well. There are reports of TENS being used for neurogenic voiding dysfunction secondary to myelomeningocele with 9/12 children having improvement on the urinary incontinence score [38]. With regard to non-neurogenic voiding dysfunction, TENS has been used successfully in 42 patients, 50% success at average follow up of 21 months.…”

Section: Cutaneous Neuromodulation (Tens)mentioning

confidence: 99%

Neuromodulation for Neurogenic Bladder

Powell

2013

Curr Bladder Dysfunct Rep

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Although neuromodulation is well established for the treatment of non-neurogenic lower urinary tract symptoms, recent literature supports its use in the patient having LUTS associated with a neurologic condition. Sacral neuromodulation, in particular, may see new use as a modality to facilitate neurologic remodeling in spinal cord injured patients as well as children. As a therapeutic option, sacral neuromodulation and dorsal genital nerve stimulation may one day become more effective and more efficient utilizing the concept of closed-loop feedback, where electro-neurogram and bladder pressure data are incorporated into stimulation routines. In addition, some older therapies are reviewed that have recently demonstrated success in this patient population.

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Efficacy of transcutaneous functional electrical stimulation on urinary incontinence in myelomeningocele: results of a pilot study

Cited by 8 publications

References 24 publications

Outcomes of electrical stimulation of the neurogenic bladder: Results of a two-year follow-up study

Outcomes of electrical stimulation of the neurogenic bladder: Results of a two-year follow-up study

Efficacy of Salvage Interferential Electrical Stimulation Therapy in Patients With Medication-Refractory Enuresis: A Pilot Study

Neuromodulation for Neurogenic Bladder

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