title: Evaluation of constipation after parasacral transcutaneous electrical nerve stimulation in children with lower urinary tract dysfunction--a pilot study.
abstract: OBJECTIVE
  To evaluate the efficacy of parasacral transcutaneous electrical nerve stimulation (TENS) for the treatment of constipation in children with lower urinary tract dysfunction (LUTD).
  
  
  METHODS
  We treated 9 boys and 5 girls with a mean age of 8.07 ± 2.72 years. 10 (71.4%) had overactive bladder and 4 (28.6%) had voiding dysfunction. A total of 20 parasacral TENS sessions, 20 min each (10 Hz), were performed 3 times per week. The criteria used to assess constipation were the Rome III criteria for children, the Bristol Stool Chart, and a visual analog scale (pain from 0 to 10). The children were reassessed immediately after treatment. No specific treatment of constipation was performed.
  
  
  RESULTS
  After treatment, 85.7% (p < 0.001) of the children's constipation symptoms had improved following the Rome III criteria. Parasacral TENS significantly impacted the following symptoms: "the presence of at least one episode of fecal incontinence per week", "history of stool retention", and "the presence of a large fecal mass in the rectum." There was no significant change in the Bristol Stool Chart evaluation (p < 0.25), but there was a significant improving trend in level of pain before and after treatment (p < 0.063). All urinary symptoms evaluated showed improvement after TENS treatment. There was a decrease in post-void residual urine.
  
  
  CONCLUSIONS
  In this first study to evaluate the results of parasacral TENS on constipation in children with LUTD, satisfactory results were obtained for both complaints.
authors.affiliation: CEDIMI, Center for Childhood Urinary Disorders, Bahiana School of Medicine, Bahia, Brazil.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Veiga
authors.forename: Patrícia
authors.initials: P
authors.lastname: Lordêlo
authors.forename: Tiago
authors.initials: T
authors.lastname: Farias
authors.forename: Ubirajara
authors.initials: U
authors.lastname: Barroso
mesh_terms: D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000628:therapy*; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome