Foot stimulation reduces bedwetting frequency among children with nocturnal enuresis
Transcutaneous foot stimulation shows utility as a non-invasive, at-home treatment for reducing the number of bedwetting episodes in children with nocturnal enuresis, according to a recent study.
A total of 22 paediatric patients (mean age 11.4 years) with ≥2 bedwetting episodes per week for at least 3 consecutive months were included in the study. All patients received a 60-minute session of stimulation of peripheral tibial nerve branches nightly for 2 weeks.
The patients kept a nighttime voiding diary for 6 weeks: 2 weeks prior to the stimulation, 2 weeks during the intervention, and 2 weeks post-stimulation.
Overall, the intervention produced a significant reduction in mean total wet nights from 9 at baseline to 6.8 during the stimulation period (p<0.01). This reduction was sustained during the post-stimulation period (7.2 wet nights; p=0.02).
A reduction of at least 1 episode of bedwetting occurred in 72.7 percent of the patients during the stimulation period. The mean number of wet nights improved from 7.9 to 4.8 (p<0.01). The improvement was maintained at a mean of 5.1 during the post-stimulation period (p<0.01).
The beneficial effect of electrical stimulation of somatic afferent pathways (in the pudendal nerve, posterior tibial nerve, or sacral spinal roots) on bladder activity is well-established. This method has been shown to be effective in both humans and animals. However, sacral and pudendal neuromodulation involves a stimulator implant, while tibial nerve neuromodulation requires percutaneous insertion of a needle electrode cephalad to the medial malleolus. These treatments are inconvenient and costly. [BJUI 2011;107;303–309]
The current data highlight the potential of noninvasive transcutaneous stimulation of somatic nerves in the foot in the management of nocturnal enuresis in children.