Department of Surgery, Division of Urology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais (DMdO, LIdSdP, AAdF, CAdS, JMBN), Brazil; Department of Surgery, Division of Urology, State University of Feira de Santana, Feira de Santana, Bahia (JdB), Brazil.
J Urol. 2013 Oct;190(4):1359-63. doi: 10.1016/j.juro.2013.03.108. Epub 2013 Mar 29.
Parasacral transcutaneous electrical neural stimulation is widely used to treat hyperactive bladder in children and adults. Its use in nonmonosymptomatic enuresis has demonstrated improvement in number of dry nights. We assessed the effectiveness of parasacral transcutaneous electrical neural stimulation in the treatment of monosymptomatic primary enuresis.
This prospective randomized clinical trial included 29 girls and 16 boys older than 6 years with primary monosymptomatic enuresis. Children were randomly divided into 2 groups consisting of controls, who were treated with behavioral therapy, and an experimental group, who were treated with behavioral therapy plus 10 sessions of parasacral transcutaneous electrical neural stimulation. Neural stimulation was performed with the electrodes placed in the sacral region (S2/S3). Sessions always followed the same pattern, with duration of 20 minutes, frequency of 10 Hz, a generated pulse of 700 μs and intensity determined by the sensitivity threshold of the child. Sessions were done 3 times weekly on alternate days. Patients in both groups were followed at 2-week intervals for the first month and then monthly for 6 consecutive months.
Rate of wet nights was 77% in controls and 78.3% in the experimental group at onset of treatment (p = 0.82), and 49.5% and 31.2%, respectively, at the end of treatment (p = 0.02). Analyzing the average rate of improvement, there was a significantly greater increase in dry nights in the group undergoing neural stimulation (61.8%) compared to controls (37.3%, p = 0.0038). At the end of treatment percent improvement in children undergoing electrical stimulation had no relation to gender (p = 0.391) or age (p = 0.911).
Treatment of primary monosymptomatic enuresis with 10 sessions of parasacral transcutaneous electrical neural stimulation plus behavioral therapy proved to be effective. However, no patient had complete resolution of symptoms.
骶旁经皮电神经刺激广泛用于治疗儿童和成人的膀胱过度活动症。其在非单一症状性遗尿症中的应用已证明可增加夜间干燥的次数。我们评估了骶旁经皮电神经刺激在治疗单一症状性原发性遗尿症中的有效性。
这项前瞻性随机临床试验纳入了 29 名女孩和 16 名年龄大于 6 岁的原发性单一症状性遗尿症男孩。患儿随机分为两组，对照组接受行为疗法治疗，实验组接受行为疗法加 10 次骶旁经皮电神经刺激治疗。神经刺激使用放置在骶区（S2/S3）的电极进行。治疗方案均相同，每次 20 分钟，频率 10Hz，脉冲 700μs，强度根据患儿的敏感阈值确定。每周治疗 3 次，隔天进行。两组患者在第一个月内每 2 周随访一次，然后连续 6 个月每月随访一次。
治疗开始时，对照组和实验组夜间湿尿率分别为 77%和 78.3%（p=0.82），治疗结束时分别为 49.5%和 31.2%（p=0.02）。分析平均改善率，接受神经刺激组夜间干燥率显著增加（61.8%），而对照组为（37.3%）（p=0.0038）。治疗结束时，接受电刺激的患儿的改善百分比与性别（p=0.391）或年龄（p=0.911）无关。
骶旁经皮电神经刺激联合行为疗法治疗单一症状性原发性遗尿症有效。然而，没有患者的症状完全缓解。
