Transcutaneous interferential electrical stimulation for the management of
non-neuropathic underactive bladder in children: a randomised clinical trial.
Author(s): Kajbafzadeh AM(1), Sharifi-Rad L(2), Ladi-Seyedian SS(1), Mozafarpour S(1).
Affiliation(s): Author information:
(1)Department of Pediatric Urology, Pediatric Urology Research Center, Children's
Hospital Medical Center, Pediatric Center of Excellence, Tehran University of
Medical Sciences, Tehran, Iran. (2)Department of Physical Therapy, Children's
Hospital Medical Center, Pediatric Center of Excellence, Tehran University of
Medical Sciences, Tehran, Iran.
Publication date & source: 2015, BJU Int. ,
OBJECTIVES: To assess the efficacy of transcutaneous interferential electrical
stimulation (IFES) and urotherapy in the management of non-neuropathic
underactive bladder (UAB) in children with voiding dysfunction.
PATIENTS AND METHODS: In all, 36 children with UAB without neuropathic disease
[15 boys, 21 girls; mean (sd) age 8.9 (2.6) years] were enrolled and then
randomly allocated to two equal treatment groups comprising IFES and control
groups. The control group underwent only standard urotherapy comprising diet,
hydration, scheduled voiding, toilet training, and pelvic floor and abdominal
muscles relaxation. Children in the IFES group likewise underwent standard
urotherapy and also received IFES. Children in both groups underwent a 15-session
treatment programme twice a week. A complete voiding and bowel habit diary was
completed by parents before, after treatment, and 1 year later. Bladder
ultrasound and uroflowmetry/electromyography were performed before, at the end of
treatment course, and at the 1-year follow-up.
RESULTS: The mean (sd) number of voiding episodes before treatment was 2.6 (1)
and 2.7 (0.76) times/day in the IFES and control groups, respectively, which
significantly increased after IFES therapy in IFES group, compared with only
standard urotherapy in the control group [6.3 (1.4) vs 4.7 (1.3) times/day, P <
0.002). The mean (sd) bladder capacity before treatment was 424 (123) and
463 (121) mL in the control and IFES groups, respectively, which decreased
significantly at 1 year after treatment in the IFES group compared with the
controls, at 227 (86) vs 344 (127) mL (P < 0.01). Maximum urine flow increased
and voiding time decreased significantly in the IFES group compared with controls
at the end of treatment sessions and 1 year later (P < 0.05). All the children
had abnormal flow curves at the beginning of the study. The flow curve became
normal in 14/18 (77%) of the children in the IFES group and six of 18 (33%) in
the control group by the end of follow-up (P < 0.007). At the end of the
treatment course, night-time wetting was improved in all children who had this
symptom before the treatment in the IFES group (P < 0.01).
CONCLUSION: Combining IFES and urotherapy is a safe and effective therapy in the
management of children with UAB.
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