The effects of transcutaneous nerve stimulation on incontinence, constipation and urodynamic parameters in pediatric patients with myelomeningocele

ABSTRACT

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.