title: Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele.
abstract: OBJECTIVE
  We describe the efficacy of transcutaneous interferential (IF) electrical stimulation on constipation symptoms in children with myelomeningocele (MMC).
  
  
  METHODS
  MMC children (30, comprising of 17 girls and 13 boys), mean age 6.7 ± 2.9, with moderate to severe intractable constipation were enrolled in this study. They were divided into treatment (IF stimulation, 15 children) and control (sham stimulation, 15 children) groups. All children underwent anorectal manometry before and 6 months after IF therapy considering the rectoanal inhibitory reflex and sphincter pressure. Parents were instructed to complete a bowel habit diary by providing data on the number of defecations per week, form of stool and episodes of pain during defecation. According to parents' report a total neurogenic bowel dysfunction score questionnaire was filled before and 6 months after treatment. A 15-course abdominal area IF electrical stimulation was performed for 20 min and three times per week, with low-frequency current in a duration of 250 μs every 6 s. Children were followed up for a minimum period of 6 months.
  
  
  RESULTS
  In the treatment group, sphincter pressure and rectoanal inhibitory reflex significantly improved compared with sham stimulation and pretreatment measures (P < .05). In 73% of patients, the characteristics of constipation decreased immediately after IF therapy, while in 53% patients, they persisted for 6 months. Frequency of defecation increased statistically significant from 2.5 ± 1.1 per week before treatment to 4.7 ± 2.3 per week after treatment (P < .001).
  
  
  CONCLUSIONS
  This pilot study showed that IF therapy is safe, noninvasive, and effective modality to improve constipation symptoms and anorectal manometry parameters in children with history of myelomeningocele.
authors: Pediatric Urology Research Center, Department of Pediatric Urology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran. kajbafzd@sina.tums.ac.ir
authors: Abdol-Mohammad
authors: AM
authors: Kajbafzadeh
authors: Lida
authors: L
authors: Sharifi-Rad
authors: Farideh
authors: F
authors: Nejat
authors: Majid
authors: M
authors: Kajbafzadeh
authors: Hamid-Reza
authors: HR
authors: Talaei
mesh_terms: D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D003710:Demography; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology*; D055496:Neurogenic Bowel / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*