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Pediatric Surgery International

, Volume 30, Issue 6, pp 663–668 | Cite as

Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial

  • Abdol-Mohammad KajbafzadehEmail author
  • Lida Sharifi-Rad
  • Seyedeh Sanam Ladi Seyedian
  • Ahmad Masoumi
Original Article

Abstract

Purpose

To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).

Methods

Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.

Results

Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0–3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).

Conclusion

This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.

Keywords

Functional electrical stimulation Myelomeningocele Neuropathic bladder Urinary incontinence 

Abbreviations

FES

Functional electrical stimulation

MMC

Myelomeningocele

UDS

Urodynamic study

DLPP

Detrusor leak point pressure

MMBC

Mean maximal bladder capacity

MMDP

Mean maximal detrusor pressure

ICCS

International children’s continent society

Notes

Acknowledgments

We are highly grateful to Dr. Kourosh Afshar Associate Professor of Pediatric Urology at the Department of Urology, British Columbia’s Children’s Hospital, Vancouver, Canada, for his final editing and invaluable comments on this manuscript.

Conflict of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Abdol-Mohammad Kajbafzadeh
    • 1
    Email author
  • Lida Sharifi-Rad
    • 2
  • Seyedeh Sanam Ladi Seyedian
    • 1
  • Ahmad Masoumi
    • 1
  1. 1.Pediatric Urology Research Center and Department of Pediatric Urology, Children’s Hospital Medical Center, Pediatric Center of ExcellenceTehran University of Medical SciencesTehranIran (IRI)
  2. 2.Department of Physical Therapy, Children’s Hospital Medical Center, Pediatric Center of ExcellenceTehran University of Medical SciencesTehranIran (IRI)

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