Efficacy of transcutaneous electric nerve stimulation [TENS] therapy in overactive non-neurogenic neurogenic bladder [Hinman's Syndrome]

ABSTRACT

To compare the outcome of the patients of overactive non-neurogenic neurogenic Bladder Syndrome with traditional treatment alone and traditional treatment plus Transcutaneous electrical nerve stimulation [TENS] therapy. Twenty eight patients of Hinmans syndrome [all below 12 years] were recruited for the study at The Children's Hospital and The Institute of Child Health Multan, from August 2008 to November 2010. It was a randomized controlled trial and individual patients were categorized as having mild moderate or severe disease, on the basis of Overactive Non-neurogenic neurogenic bladder symptom score [OABSS] scoring system. The patients with equal grades of severity were placed in control and study groups each comprising 14 patients. Group A was given traditional treatment while group B was treated with TENS therapy in addition to traditional treatment. Improvement was observed by OABSS and voiding diaries. After 12 weeks of treatment, the patients were re-evaluated for their symptoms and grade of severity of disease, t-test was applied to compare outcome between two groups and p < 0.05 was considered to be statistically significant. At the start of treatment, dribbling and increased frequency was observed in all 28 patients and urgency was noted in 22 patients [11 patients in each group]. At the completion of treatment after 12 weeks, dribbling was observed in 11[78.51%] vs. 3[21.4%] children in group A and B respectively. Frequency was reduced to 8[57.14%] in group A and 5[35.7%] in group B patients. Urgency was also reduced to 8[72.7%] in group A while 3[27.3%] in group B patients. No marked side affect were noted, except local skin irritation in some patients. Transcutaneous electrical nerve stimulation [TENS] Therapy is an effective and safe tool to improve the symptoms and quality of life of the patients with Hinman syndrome but still large scale studies with longer follow up are required