Eletroestimulação nervosa transcutânea parassacral uma vez por semana no tratamento da bexiga hiperativa em crianças - um estudo de não inferioridade

Abstract

Introduction: Overactive bladder (OAB) is the most prevalent voiding disorder in childhood, with voiding urgency as its main manifestation. Parasacral transcutaneous electro nerve stimulation (PTENS) was introduced as a safe, well-tolerated and sideeffect-free alternative treatment in children with OAB. However, the treatment protocols described require several weekly sessions, which can make treatment adherence difficult. Thus, the present study intends to compare the effects of PTENS performed with single weekly sessions to PTENS performed three times per week in the treatment of children with idiopathic overactive bladder. Methods: A randomized controlled non-inferiority clinical trial was performed, in which 22 children were randomized into two groups: G1s (TPNS once a week and urotherapy) and G3s (TPNS 3 times a week and urotherapy). In both groups, 20 sessions of 20 minutes were performed, with a frequency of 10Hz and pulse width of 700µs. The children were reassessed at the end of the 20 sessions. Results: No differences were found between the groups after the treatment regarding urinary frequency (p=0.06), urgency (p>0.99), incontinence (p=0.38), caregiver's subjective perception assessed by the visual analogue scale (p=0.74), percentage of dry nights in enuretic children (p=0.67), constipation assessed using the Rome III criteria (p=0.31) and of the Bristol Scale (p=0.09), and in the volumetric measurements evaluated by voiding diary such as maximum voiding volume (p=0.90) and mean voiding volume (p=0.38). Conclusion: PTENS performed with single weekly sessions was not inferior to that performed three times a week in the treatment of overactive bladder in children.