title: Electrical stimulation for lower urinary tract dysfunction in children: a systematic review of the literature.
abstract: OBJECTIVE
  To review studies using electrical neural stimulation (ENS), to treat children with non-neurogenic lower urinary tract dysfunctions (LUTD), and to establish the efficacy of this treatment.
  
  
  METHODS
  This review was based on an electronic search of the MEDLINE database and the Cochrane Central Search library, from January 1990 to March 2010.
  
  
  METHODS
  (1) participants aged 0-17 years, (2) participants with a diagnosis of LUTD not related to congenital abnormalities or neurological disease, (3) English language, and (4) treatment by ENS.
  
  
  RESULTS
  Seventeen papers were evaluated. Type of ENS varied among studies: sacral transcutaneous ENS in seven, sacral implanted device in four, posterior tibial percutaneous in three, and anogenital, endoanal, and intravesical in one each. There were two randomized clinical trials. Clarity regarding the LUTD being treated was variable. The populations studied were not homogeneous. The duration of treatment and the number of sessions a week were variable among the studies. Electrical parameters used also varied. A range of subjective and objective measures was used to measure treatment success. Rates of complete resolution of the symptoms of OAB, urgency, and daytime incontinence ranged from 31% to 86% [Trsinar and Kraij, Neurourol Urodyn 15: 133-42, 1996; Hagstroem et al., J Urol 182: 2072-8, 2009], 25% to 84% [Hoebeke et al., J Urol 168: 2605-8, 2002; Lordêlo et al., J Urol 182: 2900-4, 2009], 13% to 84% [Malm-Buatsi et al., Urology 70: 980-3, 2007; Lordêlo et al., J Urol 184: 683-9, 2010], respectively. For sacral transcutaneous ENS recurrence ranged from 10% to 25%. Apart from the sacral implantation studies, any reported side effects were mild and transitory.
  
  
  CONCLUSIONS
  The literature in the area of interest is sparse. Parasacral TENS has been shown to be more effective than sham in randomized trials in treating OAB. This deserves further research to elucidate the optimal parameters and the children for whom it is most useful.
authors: Urology Department, CEDIMI (Centro de Distúrbios Miccionais na Infância), Bahiana School of Medicine, Salvador, Bahia, Brazil. ubarroso@uol.com.br
authors: Ubirajara
authors: U
authors: Barroso
authors: Rafael
authors: R
authors: Tourinho
authors: Patrícia
authors: P
authors: Lordêlo
authors: Piet
authors: P
authors: Hoebeke
authors: Janet
authors: J
authors: Chase
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome; D014551:Urinary Tract / Q000294:innervation / Q000503:physiopathology*; D014563:Urodynamics