Influence of the duration of treatment on the effectiveness of anal maximal electrical stimulation in children with nonneurogenic overactive bladder and micturition problems

Abstract

BACKGROUND: To compare the effectiveness of one-month and two-month courses of maximal electrical stimulation (MES) in treating children with non-neurogenic overactive bladder and micturition problems. METHODS 90 girls with cystometrically confirmed idiopathic detrusor hyperactivity associated with nocturnal enuresis and/or daytime urinary incontinence were enrolled in a prospective, randomized study and underwent pelvic floor stimulation treatment 20 minutes a day for either one month (45 girls) or two months (45 girls). All nocturnal and diurnal incontinence episodes were recorded for one month before the start of treatment and one month after its completion. Cystometry was performed one week before the beginning of treatment and one month after its completion. The Wilcoxon matched-pair test and Mann-Whitney test were used for statistical evaluation. RESULTS After treatment with MES, 17 out of 90 patients were not included in the processing of statistical data. Thirty girls treated for one month had a significant decrease in the median num-ber of monthly nocturnal incontinence episodes (from 9.5 to 4.5, p < 0.05); 43 girls treated for two months had a significant reduction in the median number of monthly nocturnal incontinence episodes (from 14.5 to 7.5, p < 0.001) as well as in the median number of monthly daytime incontinence episodes (from 5 to 0, p < 0.01). However, the changes in clinical parameters observed after treatment with MES did not differ significantly between the two groups. In the one-month group only the number of involuntary detrusor contractions changed significantly (from 3 to 1, p < 0.05). In the two-month group there was a significant change in the number of involuntary detrusor contractions (from 2 to 0, p < 0.01) as well as in the maximum cystometric capacity (from 250 to 280 ml, p < 0.001) and compliance (from 12.5 to 20.5 ml/cm, p < 0.001). Again, the changes in cystometric parameters did not differ significantly between the two groups. CONCLUSIONS The two-month MES used in treating children with non-neurogenic overactive bladder and micturition problems had somewhat better but statistically insignificant clinical and cystometric results compared to the one-month MES.