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Superficial parasacral electrical stimulation to overactive bladder in children. a randomized clinical triAL
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ESPU Programme 2009
# S11-10 (O) SUPERFICIAL PARASACRAL ELECTRICAL STIMULATION TO OVERACTIVE BLADDER IN CHILDREN. A RANDOMIZED CLINICAL TRIAL ˆLO3 and Patricia LORDE ˆLO2 Ubirajara BARROSO1, Alcina TELES2, Maria Luiza VEIGA2, Mauricio LORDE 1
Federal University of Bahia and Bahiana School of Medicine, Urology, Salvador, BRAZIL, 2Bahiana School of Medicine, Physiotherapy, Salvador, BRAZIL, 3Bahiana School of Medicine, Urology, Salvador, BRAZIL
PURPOSE To evaluate the effectiveness of SPES to treat overactive bladder(OB) in children by the means of randomized clinical trial.
MATERIAL AND METHODS To evaluate the effectiveness of SPES to treat overactive bladder in children by the means of randomized clinical trial. Methodology: In a prospective, randomized clinical trial and blind study, 36 children e 24 girls and 12 boys emean age of 6.9 years (4-12), were separated in two groups e the test group-TG (SPES) and the sham group-SG (superficial scapular electrical stimulation-SSES). It was performed 20
sessions (10 Hz) of 20 minutes each, 3 times a week. We used 4 criteria to evaluate the rate of success: self report of cured, significant, mild or no improvement; analogical visual scale (AVS e 0 was the lowest and 10 the highest success); % of improvement and a modified Toronto score. The mean followup was 7.2 months (1-18).
in the SG scored higher than 7. Considering the % of improvement all patients had at least 80% of improvement (12 had 100%) while in the SG no one had 100% and 14 had less than 50% of improvement. The score of Toronto improved significantly in the TG and did not improve in the SG. After SSES, 14 in the SG underwent PSES: 10 were cured and 4 improved significantly.
RESULTS 33 patients concluded the treatment (19 in the TG and 14 in the SG). In the TG 63.2% and 37.8% of the parents reported cure and significantly improvement. In the SG this was reported in zero and 21.4%, respectively (p < 0,001). Regarding AVS patients scored at least 8 scale and only 1
CONCLUSIONS To our knowledge this is the first a randomized clinical trial to prove that superficial para sacral electrical stimulation is effective to treat OB in children.
# S11-11 (O) EFFECT OF TRANSCUTANEOUS NEUROMODULATION ON -OVERACTIVE BLADDER SYMPTOMS IN CHILDREN Charlotte ARFWIDSSON1, Monika DOROSZKIEWICZ1, Helena ANTONSSON2, ˚LKLINT4 and Sill ULLAE ´N5 Inger JANSSON3, Agneta LUNDH4, Malin STA ¨S, Bora˚s, Urotherapeutic unit, Bora˚s, SWEDEN, 3NA ¨L, The Queen Silvia Childrens Hospital, Urotherapeutic Unit, Go¨teborg, SWEDEN, 2SA 4 ¨ttan, SWEDEN, KSS Sko ¨ vde, Urotherapeutic Unit, Sko ¨vde, SWEDEN, 5The Queen Silvia Childrens Hospital, Urotherapeutic Unit, Trollha ¨ teborg, SWEDEN PUNC, Go 1
PURPOSE The aim was to investigate if transcutaneous neuromodulation (TENS) can be an effective complement to standard urotherapy, in the treatment of children with overactive bladder (OAB).
30 mA, and the stimulation was applied 20 minutes, twice every day. Surface electrodes were placed on the back at the level of the sacral roots. The treatment period was 12 weeks. The effect variables were taken from 3-days voiding diary.
RESULTS MATERIAL AND METHODS 60 children (33 boys) with symptoms of OAB were included at a median age of 8 years. They were randomized into two groups. Group 1 was treated with standard urotherapy alone and group 2 with a combination of standard urotherapy and TENS. Stimulation variables were 10 Hz and
Subjective experience showed a clear improvement (p < 0.0001) in both group 1 (73%) and group 2 (81%), but with no difference between the groups. This subjective experience was supported by objective findings: Leakage was improved in 81% (from 2.1 to 0.7 n/day) and 79% (from1.6 to 0.4 n/day) in group 1 and group 2,
respectively. Totally 60% had no leakage at the end of the study, with no difference between the groups. The decrease in number of voiding in group 1 (-1.3 n/day) and group 2 (-1.4 n/day) did not differ, but the decrease from start to end of the study totally was sign (p 0.006). Interestingly, the 14 patients that were previously treated had a poorer treatment result in both groups.
CONCLUSIONS TENS does not seem to have any additional beneficial effect on incontinence and frequency of voiding in children with the OAB, beside standard therapy.
ESPU Programme 2009
# S11-10 (O) SUPERFICIAL PARASACRAL ELECTRICAL STIMULATION TO OVERACTIVE BLADDER IN CHILDREN. A RANDOMIZED CLINICAL TRIAL ˆLO3 and Patricia LORDE ˆLO2 Ubirajara BARROSO1, Alcina TELES2, Maria Luiza VEIGA2, Mauricio LORDE 1
Federal University of Bahia and Bahiana School of Medicine, Urology, Salvador, BRAZIL, 2Bahiana School of Medicine, Physiotherapy, Salvador, BRAZIL, 3Bahiana School of Medicine, Urology, Salvador, BRAZIL
PURPOSE To evaluate the effectiveness of SPES to treat overactive bladder(OB) in children by the means of randomized clinical trial.
MATERIAL AND METHODS To evaluate the effectiveness of SPES to treat overactive bladder in children by the means of randomized clinical trial. Methodology: In a prospective, randomized clinical trial and blind study, 36 children e 24 girls and 12 boys emean age of 6.9 years (4-12), were separated in two groups e the test group-TG (SPES) and the sham group-SG (superficial scapular electrical stimulation-SSES). It was performed 20
sessions (10 Hz) of 20 minutes each, 3 times a week. We used 4 criteria to evaluate the rate of success: self report of cured, significant, mild or no improvement; analogical visual scale (AVS e 0 was the lowest and 10 the highest success); % of improvement and a modified Toronto score. The mean followup was 7.2 months (1-18).
in the SG scored higher than 7. Considering the % of improvement all patients had at least 80% of improvement (12 had 100%) while in the SG no one had 100% and 14 had less than 50% of improvement. The score of Toronto improved significantly in the TG and did not improve in the SG. After SSES, 14 in the SG underwent PSES: 10 were cured and 4 improved significantly.
RESULTS 33 patients concluded the treatment (19 in the TG and 14 in the SG). In the TG 63.2% and 37.8% of the parents reported cure and significantly improvement. In the SG this was reported in zero and 21.4%, respectively (p < 0,001). Regarding AVS patients scored at least 8 scale and only 1
CONCLUSIONS To our knowledge this is the first a randomized clinical trial to prove that superficial para sacral electrical stimulation is effective to treat OB in children.
# S11-11 (O) EFFECT OF TRANSCUTANEOUS NEUROMODULATION ON -OVERACTIVE BLADDER SYMPTOMS IN CHILDREN Charlotte ARFWIDSSON1, Monika DOROSZKIEWICZ1, Helena ANTONSSON2, ˚LKLINT4 and Sill ULLAE ´N5 Inger JANSSON3, Agneta LUNDH4, Malin STA ¨S, Bora˚s, Urotherapeutic unit, Bora˚s, SWEDEN, 3NA ¨L, The Queen Silvia Childrens Hospital, Urotherapeutic Unit, Go¨teborg, SWEDEN, 2SA 4 ¨ttan, SWEDEN, KSS Sko ¨ vde, Urotherapeutic Unit, Sko ¨vde, SWEDEN, 5The Queen Silvia Childrens Hospital, Urotherapeutic Unit, Trollha ¨ teborg, SWEDEN PUNC, Go 1
PURPOSE The aim was to investigate if transcutaneous neuromodulation (TENS) can be an effective complement to standard urotherapy, in the treatment of children with overactive bladder (OAB).
30 mA, and the stimulation was applied 20 minutes, twice every day. Surface electrodes were placed on the back at the level of the sacral roots. The treatment period was 12 weeks. The effect variables were taken from 3-days voiding diary.
RESULTS MATERIAL AND METHODS 60 children (33 boys) with symptoms of OAB were included at a median age of 8 years. They were randomized into two groups. Group 1 was treated with standard urotherapy alone and group 2 with a combination of standard urotherapy and TENS. Stimulation variables were 10 Hz and
Subjective experience showed a clear improvement (p < 0.0001) in both group 1 (73%) and group 2 (81%), but with no difference between the groups. This subjective experience was supported by objective findings: Leakage was improved in 81% (from 2.1 to 0.7 n/day) and 79% (from1.6 to 0.4 n/day) in group 1 and group 2,
respectively. Totally 60% had no leakage at the end of the study, with no difference between the groups. The decrease in number of voiding in group 1 (-1.3 n/day) and group 2 (-1.4 n/day) did not differ, but the decrease from start to end of the study totally was sign (p 0.006). Interestingly, the 14 patients that were previously treated had a poorer treatment result in both groups.
CONCLUSIONS TENS does not seem to have any additional beneficial effect on incontinence and frequency of voiding in children with the OAB, beside standard therapy.