Experience of Intravesical Electrical Stimulation Therapy in Children with Enuresis.
- Author:
Seung Hoon LEE
1
;
Chang Hee HONG
;
Sang Won HAN
Author Information
1. Department of Urology, Yonsei University College of Medicine, Seoul, Korea. swhan@yumc.yonsei.ac.kr
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Enuresis;
Electric stimulation
- MeSH:
Child*;
Drug Therapy;
Electric Stimulation Therapy*;
Electric Stimulation*;
Enuresis*;
Humans;
Mechanoreceptors;
Reflex;
Urinary Bladder;
Urination
- From:Korean Journal of Urology
2002;43(9):748-752
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We investigated the therapeutic effect of intravesical electrical stimulation (IVES) in enuretic children who showed refractory response to drug therapy, on the basis that IVES induces direct activation of bladder A delta mechanoreceptor afferents which would result in modulation of a central micturition reflex. MATERIALS AND METHODS: Of 351 enuretic children, the 22 who showed refractory response to drug monotherapy or combination therapy were enrolled in a clinical trial with IVES and then the therapeutic results of IVES and Post-IVES additional drug therapy were evaluated. Therapeutic response was defined when the frequency of bed-wetting was reduced by more than 50%. RESULTS: The rates of therapeutic response to IVES and Post-IVES additional drug therapy were 63.6% and 89.5%, respectively. As compared with Pre-IVES drug therapy, IVES and Post-IVES additional drug therapy showed significant therapeutic effect (p<0.05). Factors such as sex, depth of sleep, attention insufficiency, family history, voiding pattern, frequency of IVES procedure, fecal symptoms and day-time voiding symptoms had no significant impact on therapeutic response to IVES in enuresis (p>0.05). However, there was significant reduction of bed-wetting after IVES in cases with improved day-time voiding symptoms after IVES (p=0.031). CONCLUSIONS: In either a case of enuresis which shows refractory response to drug therapy as a primary modality of treatment or a case of complicated enuresis, IVES and Post-IVES additional drug therapy may produce a therapeutic response.
