ESPN 50th Annual Meeting

ESPN 2017


 
EFFICACY OF 4-MONTH TENS THERAPY FOR OAB - OVERACTIVE BLADDER.
Agata Lakomy-Gawryszewska 1 Michal Maternik 1 Magdalena Drożyńska-Duklas 1 Katarzyna Jozefowicz 1 Ilona Chudzik 1 Andzrej Golebiewski 2 Aleksandra Zurowska 1

1- Department Paediatrics, Nephrology and Hypertension, Medical University of Gdansk, Poland
2- Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, Poland
 
Introduction:

Overactive bladder (OAB) is a common type of bladder dysfunction in children. Typical symptoms include urgency, frequent voiding, holding maneuvers and day-time incontinence. ICCS (International Childrens Continence Society) recommends standard urotherapy as first line treatment and either pharmacotherapy or TENS (transcutaneous electrical nerve stimulation) as second line treatment. Single studies have confirmed that TENS may be a valuable method in children, but queries are raised on the length and intensity of TENS therapy necessary to achieve response.

Material and methods:

46 children aged 5-18 years old with OAB who had not responded fully to 4-weeks standard urotherapy were included. Inclusion criteria were typical symptoms of OAB including urgency, frequent voiding, holding maneuvers and day-time incontinence. Children with urogenital malformations, constipation, increased bladder capacity >150% EBC, significant post-void residual and uroflow curve other than tower or bell-shaped were excluded. Duration of TENS therapy was planned for 4 months and was performed at home twice a day (1 hour in the morning and 1 hour in the evening) with a frequency of 2Hz. Treatment results were evaluated according to bladder diary, frequency/volume chart and uroflowmetry performed before and after TENS therapy.

Results:

A significant decrease in the number of wet-days (-2,78 from 6,74/14 days) (p=0,0004) and in the number of days with urgency episodes (-2,6 from 6,45/14 days) (p=0,0015) was observed. 8/34 (25%) children presenting day-time urge-incontinence were full responders, 10/34 (29%) were partial responders and the remaining 16/34 (47%) were non-responders according to ICCS definitions of response to treatment.  Bladder capacity remained unchanged before (average MVV 263,5ml) and after treatment (average MVV 267,1ml).

Conclusions:

TENS is an effective nonpharmacological treatment option for children with overactive bladder who have not responded to standard urotherapy. 4 months of TENS therapy is a suboptimal period to reach satisfactory results. It should be offered to children suffering from OAB symptoms as a non-invasive treatment modality alternative to pharmacotherapy.