Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
J Urol. 2021 Jun;205(6):1785-1791. doi: 10.1097/JU.0000000000001579. Epub 2021 Feb 2.
Parasacral transcutaneous electrical nerve stimulation has been used to manage lower urinary tract symptoms refractory to standard urotherapy. Nevertheless, its actual effectiveness in treatment of bladder and bowel dysfunction remains to be established. We sought to evaluate the effectiveness of parasacral transcutaneous electrical nerve stimulation in the treatment of children with bladder and bowel dysfunction.
This was a randomized clinical trial conducted with children and adolescents of 5-17 years of age diagnosed with bladder and bowel dysfunction. Patients with neurological or anatomical abnormalities of urinary or digestive tracts, those unable to attend treatment sessions 3 times a week, individuals with diabetes mellitus or diabetes insipidus and those using anticholinergic drugs or laxatives were excluded from the study. The sample was divided into 2 groups: a control group submitted to standard urotherapy plus sham electrotherapy applied to the scapular region and a treatment group submitted to urotherapy plus parasacral transcutaneous electrical nerve stimulation. All the patients were submitted to 3, 20-minute electrotherapy (parasacral transcutaneous electrical nerve stimulation or sham) sessions/week for a total of 20 sessions.
Forty patients were evaluated, 20 in the control group and 20 in the treatment group. Mean age (±standard deviation) was 8.4±2.8 years and 52.5% were male. In 15 patients (37.5%), rectal diameter was ≥3 cm. Lower urinary tract symptoms improved in both groups following treatment, with no statistically significant differences in Dysfunctional Voiding Scoring System score, lower urinary tract symptoms or uroflowmetry patterns between the groups. Intragroup evaluation showed a significant improvement in enuresis in the treatment group. There was a significant improvement in functional constipation post-intervention in treatment group compared to control group (70% vs 20%, p=0.004).
Parasacral transcutaneous electrical nerve stimulation is effective for treatment of bladder and bowel dysfunction in children and adolescents, particularly insofar as functional constipation is concerned.
骶旁经皮神经电刺激已被用于治疗对标准尿路治疗无反应的下尿路症状。然而，其在治疗膀胱和肠道功能障碍方面的实际效果仍有待确定。我们旨在评估骶旁经皮神经电刺激治疗膀胱和肠道功能障碍儿童的有效性。
这是一项针对 5-17 岁被诊断为膀胱和肠道功能障碍的儿童和青少年的随机临床试验。患有尿路或消化道神经或解剖异常、无法每周接受 3 次治疗、患有糖尿病或尿崩症以及正在使用抗胆碱能药物或泻药的患者被排除在研究之外。该样本分为两组：对照组接受标准尿路治疗加肩胛区假电疗，治疗组接受尿路治疗加骶旁经皮神经电刺激。所有患者每周接受 3 次、每次 20 分钟的电疗（骶旁经皮神经电刺激或假电疗），共 20 次。
共评估了 40 名患者，对照组 20 名，治疗组 20 名。平均年龄（±标准差）为 8.4±2.8 岁，52.5%为男性。在 15 名患者（37.5%）中，直肠直径≥3cm。两组治疗后下尿路症状均有所改善，排尿功能障碍评分系统评分、下尿路症状或尿流率模式无统计学差异。组内评估显示治疗组遗尿症显著改善。与对照组相比，治疗组治疗后功能性便秘有显著改善（70%对 20%，p=0.004）。
骶旁经皮神经电刺激对治疗儿童和青少年的膀胱和肠道功能障碍有效，特别是在功能性便秘方面。
