Barroso Ubirajara, Carvalho Marcelo Tomás, Veiga Maria Luisa, Moraes Marília Magalhães, Cunha Carolina Coelho, Lordêlo Patrícia
CEDIMI (Centro de Distúrbios da Micção em crianças), Departamento de Urologia da Divisão de Urologia Pediátrica, Escola Bahiana de Medicina e Universidade Federal da Bahia Salvador, Bahia.
Int Braz J Urol. 2015 Jul-Aug;41(4):739-43. doi: 10.1590/S1677-5538.IBJU.2014.0303.
To evaluate the urodynamic changes immediately after the first session (acute effect) and after the last session of parasacral TENS in children with idiopathic OAB.
We performed urodynamic evaluation immediately before and after the first session of parasacral TENS and immediately after the last session (7 weeks later). Only children with idiopathic isolated OAB were included. Patients with dysfunctional voiding were not included.
18 children (4 boys and 14 girls, mean age of 8.7) were included in the first analysis (urodynamic study before and immediately after the first session) and 12 agreed to undergo the third urodynamic study. Urodynamic before and immediately after the first session: There was no change in the urodynamic parameters, namely low MCC, low bladder compliance, presence of IDC, the average number of IDC, or in the maximum detrusor pressure after the first exam. Urodynamic after the last session: The bladder capacity improved in most patients with low capacity (58% vs. 8%). Detrusor overactivity was observed in 11 (92%) before treatment and 8 (76%) after. There was not a significant reduction in the average number of inhibited contractions after TENS (p=0.560) or in the detrusor pressure during the inhibited contraction (p=0.205).
There was no change in the urodynamic parameters immediately after the first session of stimulation. After the last session, the only urodynamic finding that showed improvement was bladder capacity.
评估骶旁经皮电刺激神经疗法(TENS)首次治疗后即刻(急性效应)以及最后一次治疗后,特发性膀胱过度活动症(OAB)患儿的尿动力学变化。
我们在骶旁TENS首次治疗前、首次治疗后即刻以及最后一次治疗后即刻(7周后)进行了尿动力学评估。仅纳入特发性孤立性OAB患儿,不包括排尿功能障碍患者。
18名儿童(4名男孩和14名女孩,平均年龄8.7岁)纳入首次分析(首次治疗前及首次治疗后即刻的尿动力学研究),12名同意接受第三次尿动力学研究。首次治疗前及首次治疗后即刻的尿动力学:尿动力学参数无变化,即低膀胱顺应性、低逼尿肌收缩力、存在逼尿肌不稳定收缩(IDC)、IDC平均次数,或首次检查后的最大逼尿肌压力。最后一次治疗后的尿动力学:大多数膀胱容量低的患者膀胱容量有所改善(58%对8%)。治疗前11名(92%)观察到逼尿肌过度活动,治疗后8名(76%)观察到。TENS治疗后抑制性收缩的平均次数(p = 0.560)或抑制性收缩期间的逼尿肌压力(p = 0.205)无显著降低。
首次刺激后即刻尿动力学参数无变化。最后一次治疗后,唯一显示改善的尿动力学指标是膀胱容量。