Abstract General Information

Title

PREDICTORS OF OUTCOME IN CHILDREN AND ADOLESCENTS WITH BLADDER AND BOWEL DYSFUNCTION TREATED WITH PARASACRAL TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION

Introduction and objective

Transcutaneous parasacral electrical stimulation (parasacral TENS) has emerged as a promising treatment for children with bladder and bowel dysfunction (BBD) without direct side effects. However, few studies have verified characteristics associated with a worse treatment outcome in this specific group of patients. To evaluate potential predictors of worse outcome from parasacral TENS treatment in children and adolescents with BBD.

Method

This was a retrospective cohort study of children and adolescents aged 4 to 17 years diagnosed with BBD. All patients were submited to three 20-minute transcutaneous parasacral electrical stimulation (PTENS) sessions per week for a total of twenty sessions. Lower urinary tract symptoms (LUTS) were assessed by structured questionnaire, DVSS, and visual analogic scale (VAS). Functional constipation was assessed using Rome III and IV criteria. Potential predictive factors evaluated were age, daytime incontinence, nocturia, history of urinary tract infection, presence of nocturnal enuresis, DVSS values, and urinary frequency.

Results

Fifty-two patients were included in the study. The mean age (± standard deviation) was 7.8 ± 2.7 years, with the majority being female, 59.6%. After treatment with parasacral TENS, complete LUTS response was achieved in 21 patients (40.4%). Partial response, in turn, occurred in 28 (53.8%) patients. In 3 patients (5.7%) non-response was verified. As for functional constipation, there was a complete response in 31 (67.3%) of the children. Of all participants, 16 (30.7%) achieved complete resolution of both constipation and urinary symptoms. Of all the factors evaluated, only a history of previous UTI was associated with a worse outcome from constipation treatment.

Conclusion

History of UTI was a predictor of worse outcome of BBD treated with parasacral TENS.