The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation
ABSTRACT Background: Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not r...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Urologia
2025-01-01
|
| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100403&lng=en&tlng=en |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832542243719741440 |
|---|---|
| author | Carlos Eduardo Rocha Macedo Antônio Vitor Nascimento Martinelli Braga Felipe Santos Marimpietri Beatriz Paixão Argollo Glicia Estevam de Abreu Maria Luiza Veiga da Fonseca Ana Aparecida Nascimento Martinelli Braga Ubirajara Barroso Jr. |
| author_facet | Carlos Eduardo Rocha Macedo Antônio Vitor Nascimento Martinelli Braga Felipe Santos Marimpietri Beatriz Paixão Argollo Glicia Estevam de Abreu Maria Luiza Veiga da Fonseca Ana Aparecida Nascimento Martinelli Braga Ubirajara Barroso Jr. |
| author_sort | Carlos Eduardo Rocha Macedo |
| collection | DOAJ |
| description | ABSTRACT Background: Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not respond to pTENS. Material and Methods: This retrospective case series examined patients aged 4-17 years. Patients were given subsequent treatment options, including: behavioral therapies; oxybutynin; imipramine; a combination of oxybutynin and imipramine; parasacral percutaneous electrical nerve stimulation (PENS); or a repeat course of pTENS. Outcomes were evaluated using the Dysfunctional Voiding Scoring System (DVSS) and the Visual Analogue Scale (VAS). Results: Thirty children were included, with a median age of 7 years. Patients received one or more treatments. Of these, 70% underwent monotherapy. Among them, 57% experienced complete resolution of symptoms, 28% had partial resolution and were satisfied with the results, and 14% discontinued treatment. 30% out of the whole sample continued to experience bothersome symptoms. Complete response, according to initial subsequent, was achieved in: 54% with intensified behavioral therapies, 33% with oxybutynin, and 50% with imipramine alone. The median DVSS score decreased from 7.0 to 2.0 (p=0.025), while the median VAS score increased from 80 to 100 (p<0.001). Conclusion: Children with OAB refractory to pTENS who received structured subsequent treatments showed partial response in all cases, with complete symptom resolution in half of the patients. More intensive urotherapy, medications, or repeat pTENS in combination with oxybutinin can be effective for managing this challenging condition. |
| format | Article |
| id | doaj-art-68a41ff2abf34ff0b088827800496ce8 |
| institution | Kabale University |
| issn | 1677-6119 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj-art-68a41ff2abf34ff0b088827800496ce82025-02-04T07:37:17ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192025-01-0151110.1590/s1677-5538.ibju.2024.0453The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve StimulationCarlos Eduardo Rocha Macedohttps://orcid.org/0000-0003-3601-9822Antônio Vitor Nascimento Martinelli BragaFelipe Santos MarimpietriBeatriz Paixão ArgolloGlicia Estevam de AbreuMaria Luiza Veiga da FonsecaAna Aparecida Nascimento Martinelli BragaUbirajara Barroso Jr.ABSTRACT Background: Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not respond to pTENS. Material and Methods: This retrospective case series examined patients aged 4-17 years. Patients were given subsequent treatment options, including: behavioral therapies; oxybutynin; imipramine; a combination of oxybutynin and imipramine; parasacral percutaneous electrical nerve stimulation (PENS); or a repeat course of pTENS. Outcomes were evaluated using the Dysfunctional Voiding Scoring System (DVSS) and the Visual Analogue Scale (VAS). Results: Thirty children were included, with a median age of 7 years. Patients received one or more treatments. Of these, 70% underwent monotherapy. Among them, 57% experienced complete resolution of symptoms, 28% had partial resolution and were satisfied with the results, and 14% discontinued treatment. 30% out of the whole sample continued to experience bothersome symptoms. Complete response, according to initial subsequent, was achieved in: 54% with intensified behavioral therapies, 33% with oxybutynin, and 50% with imipramine alone. The median DVSS score decreased from 7.0 to 2.0 (p=0.025), while the median VAS score increased from 80 to 100 (p<0.001). Conclusion: Children with OAB refractory to pTENS who received structured subsequent treatments showed partial response in all cases, with complete symptom resolution in half of the patients. More intensive urotherapy, medications, or repeat pTENS in combination with oxybutinin can be effective for managing this challenging condition.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100403&lng=en&tlng=enChildUrinary BladderOveractivetherapy [Subheading] |
| spellingShingle | Carlos Eduardo Rocha Macedo Antônio Vitor Nascimento Martinelli Braga Felipe Santos Marimpietri Beatriz Paixão Argollo Glicia Estevam de Abreu Maria Luiza Veiga da Fonseca Ana Aparecida Nascimento Martinelli Braga Ubirajara Barroso Jr. The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation International Brazilian Journal of Urology Child Urinary Bladder Overactive therapy [Subheading] |
| title | The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation |
| title_full | The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation |
| title_fullStr | The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation |
| title_full_unstemmed | The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation |
| title_short | The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation |
| title_sort | management of children and adolescents with overactive bladder refractory to treatment with parasacral transcutaneous electrical nerve stimulation |
| topic | Child Urinary Bladder Overactive therapy [Subheading] |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100403&lng=en&tlng=en |
| work_keys_str_mv | AT carloseduardorochamacedo themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT antoniovitornascimentomartinellibraga themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT felipesantosmarimpietri themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT beatrizpaixaoargollo themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT gliciaestevamdeabreu themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT marialuizaveigadafonseca themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT anaaparecidanascimentomartinellibraga themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT ubirajarabarrosojr themanagementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT carloseduardorochamacedo managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT antoniovitornascimentomartinellibraga managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT felipesantosmarimpietri managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT beatrizpaixaoargollo managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT gliciaestevamdeabreu managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT marialuizaveigadafonseca managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT anaaparecidanascimentomartinellibraga managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation AT ubirajarabarrosojr managementofchildrenandadolescentswithoveractivebladderrefractorytotreatmentwithparasacraltranscutaneouselectricalnervestimulation |