title: Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial.
abstract: OBJECTIVE
  To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).
  
  
  METHODS
  Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.
  
  
  RESULTS
  Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0-3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).
  
  
  CONCLUSIONS
  This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.
authors.affiliation: Pediatric Urology Research Center and Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, 62 Qarib St, Keshavarz Blvd, 1419733151, Tehran, Iran (IRI), kajbafzd@sina.tums.ac.ir.
authors.forename: Abdol-Mohammad
authors.initials: AM
authors.lastname: Kajbafzadeh
authors.forename: Lida
authors.initials: L
authors.lastname: Sharifi-Rad
authors.forename: Seyedeh Sanam
authors.initials: SS
authors.lastname: Ladi Seyedian
authors.forename: Ahmad
authors.initials: A
authors.lastname: Masoumi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D010808:Physical Examination; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome; D014463:Ultrasonography; D016482:Urinalysis; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics
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