Abstract General Information

Title

LONG TERM RESULTS OF PARASACRAL TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (PTENS) IN PAEDIATRIC OVERACTIVE BLADDER.

Introduction and objective

pTENS is as a promising method for OAB treatment in children, but there is lack of a standard treatment protocol regarding electrical parameters, session frequency and duration of treatment. The presented study was designed to evaluate long time effect of pTENS.

Method

Inclusion criteria were typical OAB symptoms. Children received an initial 4 week intensive standard urotherapy which was followed by 4 months of pTENS treatment (frequency of 2 Hz, pulse width 150 µsek, intensity up to 40 mA), twice daily for 1 hour). The results of treatment were evaluated according to objective measurements from bladder diary’s, F/V charts and uroflowmetries.

Results

Among patients with day-time incontinence evaluated immediately after 4 months of pTENS 13/41 (31%) were full responders, 11/41 (27%) were partial responders and 17/41 (41%) children were non responders. While analysing nocturnal enuresis, and 6/40 (15%) were full responders, 14/40 (35%) were partial responders and 20/40 (50%) were non responders. Regarding the urgency episodes 8/44(18%) were full responders, 22/44(50%) were partial responders and 14/44 (32%) were nonresponders. Number of days with day-time wetting decreased from 7,23/14 to 3,94/14 (p<0,05), enuresis 6,81/14 to 3,77/14 (p<0,05) and urgency episodes 7,36/14 to 3,58/14 (p<0,05).
Long term full efficacy on day-time incontinence after 6 months after cessation of therapy was observed in 13/41 (32%), partial response was noticed in 11/41 (26%) and lack of treatment response was present in 17/41 (41%) of patients. Complete resolution of nocturnal enuresis was noticed in 14/40 (35%), significant improvement in 12/40 (30%) and 14/40 (35%) were without any improvement. Analysing urge episodes 22/44 (50%) were full responders, 12/44 (27%) were partial responders and 10/44 (22%) were nonresponders.

Conclusion

pTENS use in children with OAB is an effective method resulted in significant reduction in day time wetting, urgency episodes and nocturnal enuresis. Effect of treatment remain stable after 6 months of treatment cessation.