Zivkovic Vesna D, Stankovic Ivona, Dimitrijevic Lidija, Kocic Mirjana, Colovic Hristina, Vlajkovic Marina, Slavkovic Andjelka, Lazovic Milica
Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Faculty of Medicine, University of Nis, Nis, Serbia.
Urology. 2017 Apr;102:207-212. doi: 10.1016/j.urology.2016.12.038. Epub 2016 Dec 28.
To evaluate the effects of interferential current (IC) stimulation and diaphragmatic breathing exercises (DBEs) in children with bladder and bowel dysfunction.
Seventy-nine children with dysfunctional voiding and chronic constipation who were failures of primary care interventions were included in the prospective clinical study. All the children were checked for their medical history regarding lower urinary tract symptoms and bowel habits. Physical examination, including abdominal and anorectal digital examination, was performed. Children kept a bladder and bowel diary, and underwent urinalyses and urine culture, ultrasound examination of bladder and kidneys, and uroflowmetry with pelvic floor electromyography. Eligible children were divided into 3 groups (A, B, and C). All groups were assigned education and behavioral modifications. Additionally, group A underwent DBEs and IC stimulation, whereas group B received only DBEs. The treatment was conducted for 2 weeks in the clinic in all 3 groups,. The behavioral modifications and DBEs were continued at home for 1 month. Clinical manifestations, uroflowmetry parameters, and postvoided residual urine were analyzed before and after 6 weeks of therapy.
After the treatment, significant improvement in defecation frequency and fecal incontinence was noticed only in group A (P < .001 and P < .05, respectively). These children demonstrated significant improvement in lower urinary tract symptoms and postvoided residual urine (P < .001 and P < .05, respectively). Bell-shaped uroflowmetry curve was observed in 73.3% of group A patients (P < .001).
IC stimulation and DBEs are beneficial in chronically constipated dysfunctional voiders. Further trials are needed to define the long-term effects of this program.
评估干扰电流（IC）刺激和膈肌呼吸锻炼（DBE）对膀胱和肠道功能障碍儿童的影响。
79名排尿功能障碍和慢性便秘且初级保健干预失败的儿童纳入前瞻性临床研究。所有儿童均接受了关于下尿路症状和排便习惯的病史检查。进行了体格检查，包括腹部和肛门直肠指检。儿童记录膀胱和肠道日记，并进行尿液分析、尿培养、膀胱和肾脏超声检查以及盆底肌电图尿流率测定。符合条件的儿童分为3组（A组、B组和C组）。所有组均接受教育和行为调整。此外，A组进行DBE和IC刺激，而B组仅接受DBE。3组均在诊所进行为期2周的治疗。行为调整和DBE在家中持续进行1个月。在治疗6周前后分析临床表现、尿流率参数和排尿后残余尿量。
治疗后，仅A组排便频率和大便失禁有显著改善（分别为P < 0.001和P < 0.05）。这些儿童下尿路症状和排尿后残余尿量有显著改善（分别为P < 0.001和P < 0.05）。A组73.3%的患者观察到钟形尿流率曲线（P < 0.001）。
IC刺激和DBE对慢性便秘性排尿功能障碍患者有益。需要进一步试验来确定该方案的长期效果。
