NEW YORK (Reuters Health) – When children with overactive bladder have a poor response to medical therapy, a course of transcutaneous electrical nerve stimulation (TENS) applied to the parasacral area appears to help considerably, according to small study conducted in Brazil.

The researchers note in the August issue of the Journal of Urology released ahead of print that overactive bladder is characterized by urgency, frequency, and daytime urinary incontinence. Up to 3.5% of boys and 6% of girls have daytime incontinence.

Dr. Ubirajara Barroso, Jr. and colleagues at the Bahiana School of Medicine in Salvador, Bahia, studied the effect of parasacral TENS compared with sham TENS (i.e., superficial scapular electrical stimulation) in 25 girls and 12 boys ranging in age from 4 to 12 with overactive bladder.

Treatment was given for 20 minutes 3 times weekly, for a total of 20 sessions. All the children also had behavioral training that reinforced the necessity of voiding before sleeping, increasing fluid intake, eating high-fiber foods, and not postponing voiding when experiencing urgency.

“Among the active treatment group, 61.9% of parents reported cure. In the sham group no parent reported cure (p<0.001),” the team writes. While a modified Toronto score improved significantly in the test group and sham group, “the score was reduced more significantly in the test group compared to the sham group (p=0.011),” Dr. Barroso and associates found. After the trial, 16 patients in the sham treatment group underwent parasacral TENS, and 13 of them were cured. An editorial comment accompanying the report notes that, “perhaps unsurprisingly,” both groups in the trial improved because it was performed concurrently with behavioral therapy. While advising that children with voiding dysfunction are usually best treated with behavioral and/or medical therapy, the authors say that for refractory cases “a more invasive option such as parasacral TENS or sacral neuromodulation may be appropriate.” Reference:
Transcutaneous Electrical Nerve Stimulation in Children With Overactive Bladder: A Randomized Clinical Trial


J Urol 2010;184:683-689.