Portal de Periódicos da CAPES

Artigo Produção Nacional Revisado por pares

BIBTEX RIS

Parasacral Transcutaneous Electrical Nerve Stimulation for the Treatment of Children and Adolescents with Bladder and Bowel Dysfunction: A Randomized Clinical Trial

2021; Lippincott Williams & Wilkins; Volume: 205; Issue: 6 Linguagem: Inglês

10.1097/ju.0000000000001579

1527-3792

Glícia Estevam de Abreu, Leonardo Azevedo de Souza, Maria Luiza Veiga da Fonseca, Tâmara Barreto Carneiro Barbosa, Eneida Regis Dourado de Mello, Ananda Nacif Baião Nunes, Ubirajara de Oliveira Barroso,

Kidney Stones and Urolithiasis Treatments

No AccessJournal of UrologyPediatric Urology1 Jun 2021Parasacral Transcutaneous Electrical Nerve Stimulation for the Treatment of Children and Adolescents with Bladder and Bowel Dysfunction: A Randomized Clinical TrialThis article is commented on by the following:Editorial Comment Glícia Estevam de Abreu, Leonardo Azevedo de Souza, Maria Luiza Veiga da Fonseca, Tâmara Barreto Carneiro Barbosa, Eneida Regis Dourado de Mello, Ananda Nacif Baião Nunes, and Ubirajara de Oliveira Barroso Glícia Estevam de AbreuGlícia Estevam de Abreu *Correspondence: Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Rua Eduardo José dos Santos, 147/905 Rio Vermelho, 41940-455Salvador, Bahia , Brazil telephone: +55 (71) 21084670; email: E-mail Address: [email protected] Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil , Leonardo Azevedo de SouzaLeonardo Azevedo de Souza Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil , Maria Luiza Veiga da FonsecaMaria Luiza Veiga da Fonseca Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil , Tâmara Barreto Carneiro BarbosaTâmara Barreto Carneiro Barbosa Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil , Eneida Regis Dourado de MelloEneida Regis Dourado de Mello Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil , Ananda Nacif Baião NunesAnanda Nacif Baião Nunes Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil , and Ubirajara de Oliveira BarrosoUbirajara de Oliveira Barroso Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil View All Author Informationhttps://doi.org/10.1097/JU.0000000000001579AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Parasacral transcutaneous electrical nerve stimulation has been used to manage lower urinary tract symptoms refractory to standard urotherapy. Nevertheless, its actual effectiveness in treatment of bladder and bowel dysfunction remains to be established. We sought to evaluate the effectiveness of parasacral transcutaneous electrical nerve stimulation in the treatment of children with bladder and bowel dysfunction. Materials and Methods: This was a randomized clinical trial conducted with children and adolescents of 5–17 years of age diagnosed with bladder and bowel dysfunction. Patients with neurological or anatomical abnormalities of urinary or digestive tracts, those unable to attend treatment sessions 3 times a week, individuals with diabetes mellitus or diabetes insipidus and those using anticholinergic drugs or laxatives were excluded from the study. The sample was divided into 2 groups: a control group submitted to standard urotherapy plus sham electrotherapy applied to the scapular region and a treatment group submitted to urotherapy plus parasacral transcutaneous electrical nerve stimulation. All the patients were submitted to 3, 20-minute electrotherapy (parasacral transcutaneous electrical nerve stimulation or sham) sessions/week for a total of 20 sessions. Results: Forty patients were evaluated, 20 in the control group and 20 in the treatment group. Mean age (±standard deviation) was 8.4±2.8 years and 52.5% were male. In 15 patients (37.5%), rectal diameter was ≥3 cm. Lower urinary tract symptoms improved in both groups following treatment, with no statistically significant differences in Dysfunctional Voiding Scoring System score, lower urinary tract symptoms or uroflowmetry patterns between the groups. Intragroup evaluation showed a significant improvement in enuresis in the treatment group. There was a significant improvement in functional constipation post-intervention in treatment group compared to control group (70% vs 20%, p=0.004). Conclusions: Parasacral transcutaneous electrical nerve stimulation is effective for treatment of bladder and bowel dysfunction in children and adolescents, particularly insofar as functional constipation is concerned. References 1. : The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society. Neurourol Urodyn 2016; 35: 471. Google Scholar 2. : Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics 1997; 100: 228. Google Scholar 3. : Bladder and bowel dysfunction and the resolution of urinary incontinence with successful management of bowel symptoms in children. Acta Paediatr 2013; 102: 215. Google Scholar 4. : Long-term prognosis for childhood constipation: clinical outcomes in adulthood. Pediatrics 2010; 126: e156. Google Scholar 5. : Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology 2003; 125: 357. Google Scholar 6. : Dysfunctional voiders: medication versus urotherapy?Curr Urol Rep 2017; 18: 14. Google Scholar 7. : Controversies in the management of functional constipation in children. Curr Gastroenterol Rep 2019; 21: 23. Google Scholar 8. : ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders. Neurogastroenterol Motil 2015; 27: 594. Google Scholar 9. : Agents for treatment of overactive bladder: a therapeutic class review. Proc (Bayl Univ Med Cent) 2007; 20: 307. Google Scholar 10. : Are interferential electrical stimulation and diaphragmatic breathing exercises beneficial in children with bladder and bowel dysfunction?Urology 2017; 102: 207. Google Scholar 11. : Neuromodulation for constipation: sacral and transcutaneous stimulation. Best Pract Res Clin Gastroenterol 2011; 25: 181. Google Scholar 12. : Evaluation of constipation after parasacral transcutaneous electrical nerve stimulation in children with lower urinary tract dysfunction: a pilot study. J Pediatr Urol 2013; 9: 622. Google Scholar 13. : Age-standardization in epidemiological data. Int J Epidemiol 1995; 24: 238. Google Scholar 14. : Parasacral transcutaneous electrical neural stimulation (PTENS) once a week for the treatment of overactive bladder in children: a randomized controlled trial. J Pediatr Urol 2017; 13: 263.e1. Google Scholar 15. : Transcutaneous electrical nerve stimulation in children with overactive bladder: a randomized clinical trial. J Urol 2010; 184: 683. Link, Google Scholar 16. : Health related quality of life in children with constipation-associated fecal incontinence. J Pediatr 2009; 154: 749. Google Scholar 17. : Transcutaneous electrical nerve stimulation combined with oxybutynin is superior to monotherapy in children with urge incontinence: a randomized, placebo controlled study. J Urol 2017; 198: 430. Link, Google Scholar 18. : When should we offer parasacral transcutaneous electrical nerve stimulation for pediatric patients with lower urinary tract dysfunction?J Urol 2017; 198: 263. Link, Google Scholar 19. : Constipation and lower urinary tract dysfunction in children and adolescents: a population-based study. Front Pediatr 2016; 4: 101. Google Scholar 20. : Constipation and LUTS: how do they affect each other?Int Braz J Urol 2011; 37: 16. Google Scholar 21. : Constipation in nocturnal enuresis may interfere desmopressin management success. J Pediatr Urol 2019; 15: 177.e1. Google Scholar 22. : Treatment of non-monosymptomatic nocturnal enuresis by transcutaneous parasacral electrical nerve stimulation. J Pediatr Urol 2010; 6: 486. Google Scholar 23. : Predictors of outcome in children and adolescents with overactive bladder treated with parasacral transcutaneous electrical nerve stimulation. J Pediatr Urol 2018; 14: 54.e1. Google Scholar 24. : Polyethylene glycol vs. lactulose in infants and children with functional constipation: pediatric gastroenterologist's viewpoint. Indian Pediatr 2019; 56: 418. Google Scholar 25. : Impact of an interdisciplinary approach in children and adolescents with lower urinary tract dysfunction (LUTD). J Bras Nefrol 2014; 36: 451. Google Scholar Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. See Editorial on page 1557. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByPope J (2021) Pediatric Dysfunctional Elimination: Cars and Continence—Is Electricity the Future?Journal of Urology, VOL. 205, NO. 6, (1557-1558), Online publication date: 1-Jun-2021.Tanaka S (2021) This Month in Pediatric UrologyJournal of Urology, VOL. 205, NO. 6, (1547-1548), Online publication date: 1-Jun-2021.Related articlesJournal of UrologyApr 1, 2021, 12:00:00 AMEditorial Comment Volume 205Issue 6June 2021Page: 1785-1791Supplementary Materials Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordstranscutaneous electric nerve stimulationchildlower urinary tract symptomsconstipationadolescentMetricsAuthor Information Glícia Estevam de Abreu Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil *Correspondence: Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Rua Eduardo José dos Santos, 147/905 Rio Vermelho, 41940-455Salvador, Bahia , Brazil telephone: +55 (71) 21084670; email: E-mail Address: [email protected] More articles by this author Leonardo Azevedo de Souza Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil More articles by this author Maria Luiza Veiga da Fonseca Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil More articles by this author Tâmara Barreto Carneiro Barbosa Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil More articles by this author Eneida Regis Dourado de Mello Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil More articles by this author Ananda Nacif Baião Nunes Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil More articles by this author Ubirajara de Oliveira Barroso Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil More articles by this author Expand All Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. See Editorial on page 1557. Advertisement Loading ...