Conflict of interest: none.
Article first published online: 29 JUN 2011
Copyright © 2011 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 30, Issue 8, pages 1429–1436, November 2011
How to Cite
Barroso, U., Tourinho, R., Lordêlo, P., Hoebeke, P. and Chase, J. (2011), Electrical stimulation for lower urinary tract dysfunction in children: A systematic review of the literature. Neurourol. Urodyn., 30: 1429–1436. doi: 10.1002/nau.21140
Dirk De Ridder led the review process.
- Issue published online: 19 OCT 2011
- Article first published online: 29 JUN 2011
- Manuscript Accepted: 22 MAR 2011
- Manuscript Received: 27 DEC 2010
- electrical stimulation;
- lower urinary tract
To review studies using electrical neural stimulation (ENS), to treat children with non-neurogenic lower urinary tract dysfunctions (LUTD), and to establish the efficacy of this treatment.
This review was based on an electronic search of the MEDLINE database and the Cochrane Central Search library, from January 1990 to March 2010. Inclusion criteria: (1) participants aged 0–17 years, (2) participants with a diagnosis of LUTD not related to congenital abnormalities or neurological disease, (3) English language, and (4) treatment by ENS.
Seventeen papers were evaluated. Type of ENS varied among studies: sacral transcutaneous ENS in seven, sacral implanted device in four, posterior tibial percutaneous in three, and anogenital, endoanal, and intravesical in one each. There were two randomized clinical trials. Clarity regarding the LUTD being treated was variable. The populations studied were not homogeneous. The duration of treatment and the number of sessions a week were variable among the studies. Electrical parameters used also varied. A range of subjective and objective measures was used to measure treatment success. Rates of complete resolution of the symptoms of OAB, urgency, and daytime incontinence ranged from 31% to 86% [Trsinar and Kraij, Neurourol Urodyn 15: 133–42, 1996; Hagstroem et al., J Urol 182: 2072–8, 2009], 25% to 84% [Hoebeke et al., J Urol 168: 2605–8, 2002; Lordêlo et al., J Urol 182: 2900–4, 2009], 13% to 84% [Malm-Buatsi et al., Urology 70: 980–3, 2007; Lordêlo et al., J Urol 184: 683–9, 2010], respectively. For sacral transcutaneous ENS recurrence ranged from 10% to 25%. Apart from the sacral implantation studies, any reported side effects were mild and transitory.
The literature in the area of interest is sparse. Parasacral TENS has been shown to be more effective than sham in randomized trials in treating OAB. This deserves further research to elucidate the optimal parameters and the children for whom it is most useful. Neurourol. Urodynam. Neurourol. Urodynam. 30: 1429–1436, 2011. © 2011 Wiley Periodicals, Inc.