title: Effects of transcutaneous neuromodulation (TENS) on overactive bladder symptoms in children: a randomized controlled trial.
abstract: BACKGROUND
  The aim of the present study was to investigate whether addition of transcutaneous electrical nerve stimulation (TENS) treatment improves the results of standard urotherapy in children with overactive bladder (OAB) symptoms.
  
  
  METHODS
  Sixty-two children with symptoms of OAB and incontinence were included. The children were randomized either to standard urotherapy treatment alone or a combination of standard urotherapy and TENS. The effect variables were taken from a voiding-drinking diary: number of voiding, number of incontinence episodes, and maximum voided volume.
  
  
  RESULTS
  Both treatment groups had good treatment results, with no significant difference between the groups. In the standard treatment group 13/28 (46%) were completely dry and 11/28 (40%) had a decrease in incontinence episodes, compared to 16/24 (67%) and 3/24 (13%), respectively, in the standard+TENS group (p=0.303). The number of voiding decreased in two-thirds of the patients in both groups. However, maximal voided volume only increased in the standard treatment group. Subjectively 72% and 80% considered themselves significantly improved or free of symptoms. Previous treatment was registered in 15/55 (27%). All efficacy variables decreased in those with previous treatment, but with no difference between the standard and standard+TENS treatment groups. The only difference noted was when comparing the children without previous treatment in the groups: a significantly higher proportion were completely dry in the TENS group (12/18 [71%] versus 10/22 [48%], p=0.05).
  
  
  CONCLUSIONS
  Our results showed no significant difference overall in treatment response to OAB symptoms between urotherapy only and urotherapy+TENS, whereas a tendency to difference was found in children without previous treatment. Thus with good urotherapy support, TENS only seems to have marginal additional effects on OAB symptoms.
authors.affiliation: Pediatric Uronephrology Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden. Electronic address: ulla.sillen@vgregion.se.
authors.forename: U
authors.initials: U
authors.lastname: Sillén
authors.affiliation: Pediatric Uronephrology Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Arwidsson
authors.affiliation: Pediatric Uronephrology Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Doroszkiewicz
authors.affiliation: SÄS, Västra Götaland Region, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Antonsson
authors.affiliation: NÄL, Västra Götaland Region, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Jansson
authors.affiliation: KSS, Västra Götaland Region, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Stålklint
authors.affiliation: Pediatric Uronephrology Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Abrahamsson
authors.affiliation: Pediatric Uronephrology Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Sjöström
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000628:therapy*; D014554:Urination / Q000502:physiology*
keywords: Overactive urinary bladder; Randomization; Standard urotherapy; Transcutaneous electrical nerve stimulation; Urinary incontinence