INTRODUCTION: The purpose of this study was to evaluate safety and tolerability of transcutaneous tibial nerve stimulation (TENS) in patients under 15years of age with refractory overactive bladder.
MATERIALS AND METHODS: A retrospective analysis was conducted on outcomes of TENS (1daily 20-minute session, 10Hz) in patients with refractory overactive bladder, excluding patients with neurogenic bladder. Treatment efficacy was evaluated on symptomatic improvement and voiding schedule. Healing was defined as following: no recurrence of urinary tract infection, normal urodynamic voiding parameters, no nighttime continence disorder, normal uroflowmetry.
RESULTS: Nineteen consecutive patients with refractory overactive bladder were treated from November 2010 to March 2012 (11girls, 8boys, age 12.1±2.7 years). Three patients reported only daytime voiding disorders, the others reported daytime and nighttime voiding disorders. Ten patients reported febrile urinary tract infection (1 boy, 9 girls). The average length of treatment was 6 months. Two patients were lost to follow-up. Thirteen patients had only tibial TENS; 3 patients had tibial TENS and trospium chloride or desmopressin. At 1-month assessment, 16 patients out of 17 (94%) reported symptomatic improvement. At the end of treatment, 12 patients out of 17 (70%) met healing criteria (5 boys, 7girls), without relapse within 9 months. Three boys (18%) had partial improvement (no daytime wetting, but increased daytime frequency). No patient reported side effects.
CONCLUSION: Tibial TENS is a safe, non invasive and effective treatment in refractory overactive bladder in children. The success rate is 70%, with no side effect and no relapse at the end of the treatment in our study.
Written by:
Bouali O, Even L, Mouttalib S, Moscovici J, Galinier P, Game X. Are you the author?
Service de chirurgie pédiatrique, hôpital des enfants de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France; Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 1, avenue du Professeur Jean-Poulhes, 31059 Toulouse cedex 9, France.
Reference: Prog Urol. 2015 May 25. pii: S1166-7087(15)00130-X.
doi: 10.1016/j.purol.2015.04.005
PubMed Abstract
PMID: 26022237
Article in French.