Parasacral percutaneous electrical nerve stimulation effective, safe for OAB in children
Parasacral percutaneous electrical nerve stimulation (PENS) is a safe and effective short-term approach for treating overactive bladder (OAB) in children, reports a new study.
Eighteen children (mean age 7.82±2.45 years; 11 girls) with pure OAB received parasacral PENS weekly for 20 weeks. Frequency was set at 10 Hz and pulse width at 600 µs; intensity was varied but capped at 10 mA as tolerated by the participant. The dysfunctional voiding scoring system (DVSS) was used to evaluate symptoms, while a visual analogue scale (VAS) was used to assess treatment outcomes.
Majority (n=12; 66 percent) demonstrated complete response to PENS, while the remaining responded only partially. There was no report of failure to respond. Treatment was tolerated well and no significant side effects were reported. Those with a VAS score ≤5 after 20 sessions were considered refractory to transcutaneous electrical nerve stimulation (TENS; n=10).
All symptoms evaluated showed improvements. Statistical significance (p<0.05 for all) was achieved for urinary tract infection, nocturnal enuresis, daytime incontinence, urgency and urinary frequency. DVSS scores also significantly improved from a median of 10.5 at baseline to 3 after 20 PENS sessions.
At baseline, 10 participants were determined to have constipation. Notably, 90 percent (n=9) of these children were no longer constipated by the end of the treatment (p=0.016).
“[A] randomized clinical trial will have to be conducted to compare parasacral PENS with parasacral TENS before it is possible to affirm with certainty that parasacral PENS applied once a week is as effective as parasacral TENS applied three times weekly for the treatment of OAB in children,” said researchers.