Kajbafzadeh Abdol-Mohammad, Sharifi-Rad Lida, Ladi Seyedian Seyedeh Sanam, Masoumi Ahmad
Pediatric Urology Research Center and Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, 62 Qarib St, Keshavarz Blvd, 1419733151, Tehran, Iran (IRI),
Pediatr Surg Int. 2014 Jun;30(6):663-8. doi: 10.1007/s00383-014-3503-0. Epub 2014 Apr 17.
To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).
Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.
Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0-3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).
This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.
报告经皮功能性电刺激（FES）治疗脊髓脊膜膨出（MMC）继发难治性神经性尿失禁患儿的疗效。
30例有MMC病史（12例女孩和18例男孩，平均年龄6.7±3.6岁）且患有难治性尿失禁的患儿纳入本研究。他们被随机分为治疗组（FES，15例患儿）和对照组（假刺激，15例患儿）。所有患者在FES治疗前及治疗6个月后均接受尿动力学研究（UDS），评估逼尿肌漏点压（DLPP）、平均最大逼尿肌压力和平均最大膀胱容量。还在治疗前及治疗6个月后评估每日失禁评分、更换尿垫频率和遗尿情况。进行15个疗程的FES，每次15分钟，每周3次。对患儿随访至少6个月。
在UDS变量中，治疗组DLPP从治疗前的32±10.7 cmH2O显著增加至6个月后的55.6±24.9 cmH2O（P<0.03）。与假刺激组相比，治疗组每日失禁评分（范围0 - 3）从治疗前的2.7±0.4显著改善至治疗后的1.3±0.9（P<0.02）。
这种电刺激是一种安全、无创且有效的改善脊髓脊膜膨出患儿尿失禁的方法，可在家中使用。
