Efficacy Of Interferential Electrical Simulation Versus Para-Sacral Transcutaneous Electrical Nerve Stimulation In Management Of Nocturnal Enuresis
Volume 4 - Issue 5, May 2020 Edition
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Sara Gama, Rashid Ellidir
Electrical stimulation, Interferential therapy, Nocturnal enuresis, Transcutaneous electrical nerve stimulation.
Background: Enuresis is a common childhood health problem affecting the quality of life of the child and his or her family. We have evaluated the efficacy of interferential (IF) electrical stimulation and Para-Sacral transcutaneous electrical stimulation (TENS) in children with nocturnal enuresis (NE). Objective: To study the effect of the interferential electrical simulation versus the effect of Para-sacral transcutaneous electrical stimulation in children with nocturnal enuresis. Methods: This was a randomized clinical trial in which 45 children, aged 6â€“18 years with NE were recruited and randomly divided into three groups. Children in the control group received standard urotherapy only (hydration, scheduled voiding, toilet training, diet), whereas children in the IF group underwent standard urotherapy + 12 sessions of IF electrical stimulation for 20 min three time per week and the children in the third group were treated with 12 session of Para-Sacral TENS. After the completion of the treatment program, the improvement score was calculated to identify relative decrease in wet nights for each child. All children were followed for one week before and after treatment. Results: In interferential electrical stimulation (IF) group, complete response was observed in 66.7%, partial response in 20% and13.3 % had no response. In Para-sacral transcutaneous electrical stimulation (TENS) group, full response was observed in 53.3%, partial response in 26.7% and 20% had no response. In control group, full response was observed in 13.3%, partial response in 6.7% and 80% had no response. Significant reduction in mean of number of wet nights before and after treatment was seen in interferential electrical stimulation (IF) and Para-sacral transcutaneous electrical stimulation (TENS) group (from 5.80 Â±1.47 and 6.20 Â± 1.52 to 0.73 Â± 1.22 and 1.33 Â± 1.75) respectively, P= 0.000. Conclusion: Interferential electrical stimulation (IF) and Para-sacral transcutaneous electrical stimulation (TENS) were effective in reducing the number of wet nights without causing any side effects.
. Neveus T, von Gontard A, Hoebeke P, Hjalmas K, Bauer S, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children's Continence Society. The Journal of urology. 2006; 176(1) pp:314-24.
. Naseri .M and Hiradfar. "monosymptomatic and nonmonosymptomatic nocturnal enuresis: a Clinical evaluation, "Archives of Iranian medicine. (2012); 15, (11): 702-706.
. Hagstroem S, Kamperis K, Rittig S et al. Monosymptomatic nocturnal enuresis is associated with abnormal nocturnal bladder emptying. Journal of Urology. (2004); 171: 25 - 26.
. Unvar T and Sonmez F. The role of urine osmolality and ions in the pathogenesis of primary enuresis nocturna and in the prediction of responses to desmopressin and conditioning therapies. InntUrolNephrol. (2005); 37: 751.
. Butler RJ, Redfern EJ, Forsythe WI. The childâ€™s construing of nocturnal enuresis: a method of inquiry and prediction of outcome. Journal of Child psychology and Psychiatry 1990; 31: 447â€“54.
. Butler RJ. Impact of nocturnal enuresis on children and young people. Scand J UrolNephrol (2001); 35: 169â€“76.
. Zhang D and Lu Y. clinical application of the point baihui. J Tradit Chin Med (2002); 22:224.
. Schreiner L, dos Santos TG, de souza AB, Nygaard CC, da silva Filho IG. Electrical stimulation for urinary incontinence in women: a systematic review. Braz J Urol (2013) 39(4):454-464
. Bower, W. F, Moore, K. H.: A pilot study of the home application of transcutaneous neuromodulation in children with urgency or urge incontinence. J Urol 2001; 166:2420-2422.
. Hoebeke, P., van laecke, E., Everaert, K., et al: Transcutaneous neuromodulation for the urge syndrome in children: a pilot study. JUrol 2001; 166: 2416-2419.
. Malm-Buatsi E, Nepple KG, Boyt MA, et al.: Efficacy transcutaneous electrical nerve stimulation in children with OAB refractory to pharmacotherapy. UROLOGY 2007; 70:980-983
. Barroso Jr.U, Tourinho R, Lordelo P, et al: Electrical stimulation for lower urinary tract dysfunction in children: A Systematic Review of the literature. Neurology and Urodynamics 2011: 30:1429-1436.
. Goats GC. Interferential current therapy. Br J Sports Med (1990) 24: 87-92.
. Montaldo P, Tafuro L, Rea M, Narciso V, Iossa AC, et al. Desmopressin and oxybutynin in monosymptomatic nocturnal enuresis: a randomized double-blind, placebo-controlled trial and an assessment of predictive factors. BJU Int. (2012).
. Johnson, 1997; Pope, Mockett and Wright, 1995; Reeve, Menon and corabian, 1996; Robertson and Spurritt, 1998.
. Kajbafzadeh AM, Sharifi-Rad L, Baradaran N, Nejat F. Effect of pelvic floor interferential electrostimulation on urodynamic parameters and incontinency of children with myelomeningocele and detrusor overactivity. Urology 2009; 74:324-9.
. Chase J, Robertson VJ, Southwell B, Hutson J, Gibb S. Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children. J Gastroenterol Hepatol 2005; 20: 1054-61.
. Kajbafzadeh AM, Sharifi-Rad L, Nejat F, Kajbafzadeh M, Talaei HR. Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele.Int J Colorectal Dis 2012;27:453-8.
. De Oliveira LF, de Oliveira DM, Da Silva de Paula LI, de Figueiredo AA, de Bessa J Jr, de Sa CA, Bastos Netto JM. Transcutaneous parasacral electrical neural stimulation in children with primary monosymptomatic enuresis: a prospective randomized clinical trial. J Urol (2013); 190(4):1359-1363
. Butler RJ, Golding j Northstone K. Nocturnal enuresis at 7 .5 years old: prevelance and analysis of clinical signs. BJU Int 2005; 96 (3).
. De Grazia E, Cimador M Oxybutinin-desmopressin association in the treatment of primary nocturnal enuresis with diurnal urination disorders. Minerva Pediatr (1999); 51: 149-152.
. SnajderovÃ¡ M, LehotskÃ¡ V, KocnarovÃ¡ N, KernovÃ¡ T, ArchmanovÃ¡ E, et al. Long term treatment with desmopressin in children with primary nocturnal enuresis. An international multi center study. (1999); 138: 429- 435.
. Caine P, Arena F, Biraghi M Nocturnal enuresis and daytime wetting in children with primary nocturnal enuresis. (1999) 138: 429-435.
. Fallahzadeh MH, Ebrahimian M, Fallahzadeh F, Piri A. Interferential currents as a treatment modality in children with nocturnal enuresis. J Medical Research (2002); 1: 48-53.
. Hagstroem S, Mahler B, Madsen B, Djurhuus JC, Rittig S. Transcutaneous electrical nerve stimulation for refractory daytime urinary urge incontinence. J Urol (2009); 182[4 Suppl]:2072â€“2078
. LordÃªlo P, Teles A, Veiga ML, Correia LC, Barroso U Jr. Transcutaneous electrical nerve stimulation in children with overactive bladder: a randomized clinical trial. J Urol (2010); 184(2):683â€“689