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A comparative study of transcutaneous interferential electrical stimulation and transcutaneous electrical nerve stimulation on children with primary nocturnal enuresis: a randomized clinical trial

Abstract

Introduction

Nocturnal enuresis is an infrequent uncontrolled voiding during sleep in a child aged 5 years or more without any congenital or acquired disorders of the central nervous system.

Objective

To compare immediate and short-term effects of interferential currents (IFC) and transcutaneous electrical nerve stimulation (TENS) in the treatment of children with primary nocturnal enuresis (PNE) in numbers of wet nights and quality of life (QoL).

Study design

52 children aged 7–14 (10.6 ± 1.9) having PNE, were assigned randomly into two groups (26 children for each group). Both IFC and TENS groups continued treatment session for 20 min, 3 sessions per week for 6 weeks. The outcome measures were the number of wet nights, and QoL through pediatric incontinence questionnaire (PinQ).The measurements were evaluated before treatment (Pre-), after the last session (Post-1), and 6 months later (Post-2).

Results

By comparing the Pre- and Post-1 mean values, the number of wet nights, reduced significantly (P < 0.05) in both groups, in favor of IFC group. Post-1 showed many children with full and good responses and few numbers with partial or no responses to IFC than TENS. Post-1 revealed that PinQ was significantly reduced in both groups in favor of the IFC group (P < 0.05). The values were slightly improved in both groups in Post-2, they were significantly different between Pre- and post-measurements in each group (P < 0.05). Comparison between both groups showed significant differences in the mean values between Post-1 and Post-2 in favor of IFC group (P < 0.05).

Conclusions

IFC and TENS had immediate and short-term improvements in children with PNE by reducing numbers of wet nights and enhancing QoL in favor of the IFC group.

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Fig. 1

References

  1. Nevéus T, von Gontard A, Hoebeke P, Hjälmås K, Bauer S, Bower W, Jørgensen TM, Rittig S, Walle JV, Yeung CK, Djurhuus JC (2006) The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society. J Urol 176:314–324

    Article  Google Scholar 

  2. Butler RJ, Golding J, Northstone K, ALSPAC Study Team (2005) Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU Int 96(3):404–410

    Article  Google Scholar 

  3. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Walle JV, Av Gontard, Wright A, Yang SS, Nevéus T (2015) The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children’s Continence Society. Neurourol Urodyn 35:471–481

    Article  Google Scholar 

  4. Buckley BS, Lapitan MC, Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris 2008 (2010) Prevalence of urinary incontinence in men, women, and children—current evidence: findings of the Fourth International Consultation on Incontinence. Urology 76:265–270

    Article  Google Scholar 

  5. Nevéus T (2011) Nocturnal enuresis—theoretic background and practical guidelines. Pediatr Nephrol 26:1207–1214

    Article  Google Scholar 

  6. Gladh G, Eldh M, Mattson S (2006) Quality of life in neurologically healthy children with urinary incontinence. Acta Paediatr 95:1648–1652

    Article  Google Scholar 

  7. Nevéus T (2009) Diagnosis and management of nocturnal enuresis. Curr Opin Pediatr 21:199–202

    Article  Google Scholar 

  8. Baeyens D, Roeyers H, Naert S, Hoebeke P, Vande Walle J (2007) The impact of maturation of brainstem inhibition on enuresis: a startle eye blink modification study with 2-year followup. J Urol 178:2621–2625

    Article  Google Scholar 

  9. Robson WL, Leung AK (2005) Primary and secondary nocturnal enuresis: similarities in presentation. Pediatrics 115:956–959

    Article  Google Scholar 

  10. Robson WL (2009) Clinical practice. evaluation and management of enuresis. N Engl J Med 360:1429–1436

    Article  CAS  Google Scholar 

  11. Nevéus T, Eggert P, Evans J, Macedo A, Rittig S, Tekgül S, Vande Walle J, Yeung CK, Robson L (2010) International Children’s Continence Society. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children’s Continence Society. J Urol 183:441–447

    Article  Google Scholar 

  12. Franco I, von Gontard A, De Gennaro M, International Children’s Continence Society (2013) Evaluation and treatment of nonmonosymptomatic nocturnal enuresis: a standardization document from the International Children’s Continence Society. J Pediatr Urol 9:234–243

    Article  Google Scholar 

  13. Yazdanpanah P, Ali M, Mehrabi S (2012) Assessment of interferential currents therapy efficacy in management of primary nocturnal enuresis in 5–15 years old children: a randomized clinical trial. J Nov Physiother 2:109

    Article  Google Scholar 

  14. Schreiner L, dos Santos TG, de Souza AB, Nygaard CC, da Silva Filho IG (2013) Electrical stimulation for urinary incontinence in women: a systematic review. Braz J Urol 39(4):454–464

    Article  Google Scholar 

  15. Seo JT, Yoon H, Kim YH (2004) A randomized prospective study comparing new vaginal cone and FES-Biofeedback. Yonsei Med J 45:879–884

    Article  Google Scholar 

  16. Fuentes JP, Armijo Olivo S, Magee DJ, Gross DP (2010) Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis. Phys Ther 90(9):1219–1238

    Article  Google Scholar 

  17. Kajbafzadeh AM, Sharifi-Rad L, Baradaran N, Nejat F (2009) Effect of pelvic floor interferential electrostimulation on urodynamic parameters and incontinency of children with myelomeningocele and detrusor overactivity. Urology 74:324–329

    Article  Google Scholar 

  18. Kajbafzadeh AM, Sharifi-Rad L, Nejat F, Kajbafzadeh M, Talaei HR (2012) Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele. Int J Colorectal Dis 27:453–458

    Article  Google Scholar 

  19. Samhan AF, Abd-Elhalim NM, Elnegmy EH, Elnaggar RK, Mahmoud WS (2012) Efficacy of P transcutaneous electrical nerve stimulation in treatment of children with overactive bladder. World Appl Sci J 18:343–348

    Google Scholar 

  20. Dasgupta R, Critchley HD, Dolan RJ, Fowler CJ (2005) Changes in brain activity following sacral neuromodulation for urinary retention. J Urol 174(6):2268–2272

    Article  Google Scholar 

  21. Jørgensen CS, Kamperis K, Borch L, Borg B, Rittig S (2017) Transcutaneous electrical nerve stimulation in children with monosymptomatic nocturnal enuresis: a randomized, double-blind, placebo controlled study. J Urol 198(3):687–693

    Article  Google Scholar 

  22. de Oliveira LF, de Oliveira DM, Silva Da, de Paula LI, de Figueiredo AA, de Bessa J Jr, de Sa CA, Bastos Netto JM (2013) Transcutaneous P electrical neural stimulation in children with primary monosymptomatic enuresis: a prospective randomized clinical trial. J Urol 190(4):1359–1363

    Article  Google Scholar 

  23. Jönson Ring I, Nevéus T, Markström A, Arnrup K, Bazargani F (2017) Nocturnal enuresis impaired children’s quality of life and friendships. Acta Paediatr 106:806–811

    Article  Google Scholar 

  24. Kajbafzadeh AM, Sharifi-Rad L, Mozafarpour S, Ladi-Seyedian SS (2015) Efficacy of transcutaneous interferential electrical stimulation in treatment of children with primary nocturnal enuresis: a randomized clinical trial. Pediatr Nephrol 30:1139–1145

    Article  Google Scholar 

  25. Lordêlo P, Benevides I, Kerner EG, Teles A, Lordêlo M, Barroso U Jr (2010) Treatment of non-monosymptomatic nocturnal enuresis by transcutaneous P electrical nerve stimulation. J Pediatr Urol 6:486

    Article  Google Scholar 

  26. Trontelj JV, Janko M, Godec C, Rakovec S, Trontelj M (1974) Proceedingselectrical stimulation for urinary incontinence: a neurophysiological study. Urol Int 29(3):213–220

    Article  CAS  Google Scholar 

  27. De Gennaro M, Capitanucci ML, Mosiello G, Zaccara A (2011) Current state of nerve stimulation technique for lower urinary tract dysfunction in children. J Urol 185(5):1571–1577

    Article  Google Scholar 

  28. Kajbafzadeh AM, Sharifi-Rad L, Ladi-Seyedian SS, Mozafarpour S (2016) Transcutaneous interferential electrical stimulation for the management of non-neuropathic underactive bladder in children: a randomised clinical trial. BJU Int 117:793–800

    Article  Google Scholar 

  29. Turkan A, Inci Y, Fazli D (2005) The short-term effects of physical therapy in different intensities of urodynamic stress incontinence. Gynecol Obstet Invest 59:43–48

    Article  Google Scholar 

  30. Caldwell KP (1963) The electrical control of sphincter incompetence. Lancet 2:174–175

    Article  CAS  Google Scholar 

  31. Lee HA, Park K (2013) Efficacy of salvage interferential electrical stimulation therapy in patients with medication-refractory enuresis: a pilot study. Int Neurourol J 17:139–144

    Article  Google Scholar 

  32. De Bock F, De Wachter S, Wyndaele JJ (2008) Influence of nerve transsections and combined bladder filling on intravesical electrostimulation-induced bladder contraction in the rat. Eur Urol 56:527

    Article  Google Scholar 

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NMA had complete right to use all information in this study and has the accountability for the honesty of the data and the correctness of the statistical analysis. Study idea and strategy. All authors recruiting of the manuscript: MMI made Statistical analysis.

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Correspondence to Nermeen Mohamed Abdelhalim.

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Abdelhalim, N.M., Ibrahim, M.M. A comparative study of transcutaneous interferential electrical stimulation and transcutaneous electrical nerve stimulation on children with primary nocturnal enuresis: a randomized clinical trial. Int Urol Nephrol 52, 409–415 (2020). https://doi.org/10.1007/s11255-019-02340-w

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Keywords

  • Primary nocturnal enuresis
  • Interferential currents
  • Transcutaneous electrical nerve stimulation
  • Quality of life