Effectiveness of Intra-anal Biofeedback and Electrical Stimulation in the Treatment of Children With Refractory Monosymptomatic Nocturnal Enuresis: A Comparative Randomized Controlled Trial
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Purpose: To compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE). Methods: Ninety children of both sexes aged 8–12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment. Results: After training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups. Conclusions: Both intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.
Abstract
Purpose: To compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE). Methods: Ninety children of both sexes aged 8–12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment. Results: After training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups. Conclusions: Both intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.
참고문헌 (34)
- Neveus T, "Evaluation of and treatment for monosymptomatic enuresis: a standardization document from theInternational Children’s Continence Society", J Urol, 183, pp.441~447 (2010)
- Austin PF, "The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society", J Urol, 191, pp.1863-5.e13~ (2014)
- Tugtepe H, "The effectiveness of transcutaneous electrical neural stimulation therapy in patients with urinary incontinence resistant to initial medical treatment or biofeedback", J Pediatr Urol, 11, pp.137.e1~137.e5 (2015)
- Andersson KE, "Urinary bladder contraction and relaxation:physiology and pathophysiology", Physiol Rev, 84, pp.935~986 (2004)
- Holstege G, "Central nervous system control of micturition", Int Rev Neurobiol, 56, pp.123~145 (2003)
- Podnar S, "Neurophysiological study of primary nocturnal enuresis", Neurourol Urodyn, 18, pp.93~98 (1999)
- Lv L, "Afferent pathway dysfunction in children with primary nocturnal enuresis", Int J Urol, 17, pp.182~186 (2010)
- Madill SJ, "Effects of PFM rehabilitation on PFM function and morphology in older women", Neurourol Urodyn, 32, pp.1086~1095 (2013)
- Guaderrama NM, "Evidence for the innervation of pelvic floor muscles by the pudendal nerve", Obstet Gynecol, 106, pp.774~781 (2005)
- Yamanishi T, "Biofeedback training for detrusor overactivity in children", J Urol, 164, pp.1686~1690 (2000)
- Arda E, "Primary nocturnal enuresis: a review", Nephrourol Mon, 8, pp.e35809~ (2016)
- Caldwell PH, "Management of nocturnal enuresis", pp.f6259~ (2013), BMJ
- Sancak EB, "The effectiveness of biofeedback therapy in children with monosymptomatic enuresis resistant to desmopressin treatment", Turk J Urol, 42, pp.278~284 (2016)
- Topaloğlu N, "Biofeedback in the treatment of nocturnal enuresis: may be an alternative method of treatment?", J Clin Anal Med, 6, pp.604~607 (2015)
- de Oliveira LF, "Transcutaneous parasacral electrical neural stimulation in children with primary monosymptom atic enuresis: a prospective randomized clinical trial", J Urol, 190, pp.1359~1363 (2013)
- Raheem AA, "Role of posterior tibial nerve stimulation in the treatment of refractory monosymptomatic nocturnal enuresis: a pilot study", J Urol, 189, pp.1514~1518 (2013)
- Kajbafzadeh AM, "Efficacy of transcutaneous interferential electrical stimulation in treatment of children with primary nocturnal enuresis: a randomized clinical trial", Pediatr Nephrol, 30, pp.1139~1145 (2015)
- Jørgensen CS, "Transcutaneous electrical nerve stimulation in children with monosymptomatic nocturnal enuresis: a randomized, Double-Blind, Placebo Controlled Study", J Urol, 198, pp.687~693 (2017)
- Halski T, "The evaluation of bioelectrical activity of pelvic floor muscles depending on probe location: a pilot study", Biomed Res Int, 2013, pp.238312~ (2013)
- Stania M, "Bioelectrical activity of the pelvic floor muscles during synchronous whole-body vibration--a randomized controlled study", BMC Urol, 15, pp.107~ (2015)
- Suelena M, "Effectiveness of treatment using fecal incontinence biofeedback isolated or associated with electrical stimulation", J Coloproctol, 34, pp.240~244 (2014)
- Grape HH, "Retest reliability of surface electromyography on the pelvic floor muscles", Neurourol Urodyn, 28, pp.395~399 (2009)
- Herndon CD, "Interactive computer games for treatment of pelvic floor dysfunction", J Urol, 166, pp.1893~1898 (2001)
- Hamdy S, "Laterality effects of human pudendal nerve stimulation on corticoanal pathways: evidence for functional asymmetry", Gut, 45, pp.58~63 (1999)
- Prasad V, "Effectiveness of non pharmacological therapy on bed wetting in children", J Drug Deliv Ther, 1, pp.78~80 (2011)
- Zivkovic V, "The role of pelvic floor rehabilitation in the treatment of children with dysfunctional voiding", J Pediatr Urol, 6(Suppl 1), pp.S6~S70 (2010)
- Kaye JD, "Animated biofeedback yields more rapid results than nonanimated biofeedback in the treatment of dysfunctional voiding in girls", J Urol, 180, pp.300~305 (2008)
- Bergquist AJ, "Motor unit recruitment when neuromuscular electrical stimulation is applied over a nerve trunk compared with a muscle belly: quadriceps femoris", J Appl Physiol (1985), 113, pp.78~89 (2012)
- Bickel CS, "Motor unit recruitment during neuromuscular electrical stimulation: a critical appraisal", Eur J Appl Physiol, 111, pp.2399~2407 (2011)
- De Gennaro M, "Current state of nerve stimulation technique for lower urinary tract dysfunction in children", J Urol, 185, pp.1571~1577 (2011)
- Bower WF, "A review of non-invasive electro neuromodulation as an intervention for non-neurogenic bladder dysfunction in children", Neurourol Urodyn, 23, pp.63~67 (2004)
- Van Rey FS, "Applications of neurostimulation for urinary storage and voiding dysfunction in neurological patients", Urol Int, 81, pp.373~378 (2008)
- Vonthein R, "Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review", Int J Colorectal Dis, 28, pp.1567~1577 (2013)
- Demirtürk F, "Interferential current versus biofeedback results in urinary stress incontinence", Swiss Med Wkly, 138, pp.317~321 (2008)