The Effects of Transcutaneous Nerve Stimulation on Incontinence, Constipation and Urodynamic Parameters in Pediatric Patients with Myelomeningocele

The Effects of Transcutaneous Nerve Stimulation on Incontinence, Constipation and Urodynamic Parameters in Pediatric Patients with Myelomeningocele
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Title:The Effects of Transcutaneous Nerve Stimulation on Incontinence, Constipation and Urodynamic Parameters in Pediatric Patients with Myelomeningocele
Author/Abstract:

Roderick P. Arcinas, MD and David T. Bolong, MD, FPUA Section of Urology, Department of Surgery, University of Santo Tomas Hospital

Objective: The purpose of this study was to determine the efficacy of transcutaneous nerve stimulation (TENS) in the treatment of
neurogenic bladdder secondary to myelomeningocele (MMC).

Materials and Methods: A total of 14 children (7 boys and 7 girls) with neurogenic bladder secondary to MMC who were referred to our clinic
between 2009 and 2011 were enrolled in the study. Urodynamic parameters including maximum bladder capacity (MBC) and detrusor leak point
pressure (DLPP), maximum detrusor pressure (MDP) and bladder compliance (BC), daily incontinence score, constipation, and subjective
improvement were recorded as outcome measures. After the first urodynamic session to get the baseline parameters, a 1 hour dose of TENS
once a day for at least 3 months was applied at a certain dermatomal level. This was followed by another urodynamic session to assess its
effects.

Results: Out of 14 subjects, 11 (78.5%) had improvement in continence profile and 8 (57%) had improvement in bowel movement. Thirteen out
of 14 (92%) had subjective improvements such as higher catheterized and/or voided volume, lesser bedwetting episodes, spontaneous voiding,
increased sensation to void, presence of urgency to void, and frequent voiding. One subject had no subjective improvement. The difference
in DLLP, MBC, MDP, and BC pre and post treatment was not statistically significant.

Conclusion: The efficacy of TENS in treating bladder dysfunction in patients with MMC remains uncertain. It did show slight improvement in
urodynamic parameters specifically BC and MBC however, it was not statistically significant.

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