Altered bladder and bowel function following cutaneous electrical field stimulation in children with spina bifida--interim results of a randomized double-blind placebo-controlled trial.
Bladder and bowel dysfunction in spina bifida are the result of abnormal electrical input, secondary to the neurological lesion of the spinal cord. Experimental attempts to correct this deficit with invasive electrical stimulation have demonstrated promising effects, as has a recent preliminary study of transcutaneous electro-stimulation in children with myelomeningocoele. A randomized controlled trial of non-invasive electrical stimulation in children with neuropathic bladder and bowel has been established. Interim results of 50 patients are presented. Treatment was performed at home for one hour daily for a mean period of 45 days. The only statistically significant difference between the active and placebo-groups was a 32% relative decrease in night-time urinary incontinence, favoring the placebo group. However there were non-significant trends of preferential improvement in the active group for the relative increases in maximum and average bladder content and episodes of spontaneous normal defecation. It is anticipated that a continued increase in patient numbers will overcome the large placebo effect observed and yield more significant results.
Marshall
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Department of Paediatric Surgery, Royal Belfast Hospital for Sick Children, Northern Ireland, UK.
Boston
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VE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D016135:Spinal Dysraphism / Q000150:complications / Q000503:physiopathology*; D004561:Transcutaneous Electric Nerve Stimulation; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy*