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Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial

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Abstract

Purpose

To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).

Methods

Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.

Results

Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0–3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).

Conclusion

This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.

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Abbreviations

FES:

Functional electrical stimulation

MMC:

Myelomeningocele

UDS:

Urodynamic study

DLPP:

Detrusor leak point pressure

MMBC:

Mean maximal bladder capacity

MMDP:

Mean maximal detrusor pressure

ICCS:

International children’s continent society

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Acknowledgments

We are highly grateful to Dr. Kourosh Afshar Associate Professor of Pediatric Urology at the Department of Urology, British Columbia’s Children’s Hospital, Vancouver, Canada, for his final editing and invaluable comments on this manuscript.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Pediatric Urology Research Center and Department of Pediatric Urology, Children’s Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, 62 Qarib St, Keshavarz Blvd, 1419733151, Tehran, Iran (IRI)

    Abdol-Mohammad Kajbafzadeh, Seyedeh Sanam Ladi Seyedian & Ahmad Masoumi

  2. Department of Physical Therapy, Children’s Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran (IRI)

    Lida Sharifi-Rad

Authors
  1. Abdol-Mohammad Kajbafzadeh
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  2. Lida Sharifi-Rad
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  3. Seyedeh Sanam Ladi Seyedian
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  4. Ahmad Masoumi
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Corresponding author

Correspondence to Abdol-Mohammad Kajbafzadeh.

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Kajbafzadeh, AM., Sharifi-Rad, L., Ladi Seyedian, S.S. et al. Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial. Pediatr Surg Int 30, 663–668 (2014). https://doi.org/10.1007/s00383-014-3503-0

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  • DOI: https://doi.org/10.1007/s00383-014-3503-0

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