Efficacy of transcutaneous posterior tibial nerve stimulation in children with functional voiding disorders

Ruslan Jafarov; Erman Ceyhan; Oguzhan Kahraman; Taner Ceylan; Zeliha G Dikmen; Serdar Tekgul; Hasan S Dogan

doi:10.1002/nau.24575

Efficacy of transcutaneous posterior tibial nerve stimulation in children with functional voiding disorders

Neurourol Urodyn. 2021 Jan;40(1):404-411. doi: 10.1002/nau.24575. Epub 2020 Nov 18.

Authors

Ruslan Jafarov¹, Erman Ceyhan¹, Oguzhan Kahraman¹, Taner Ceylan², Zeliha G Dikmen³, Serdar Tekgul², Hasan S Dogan²

Affiliations

¹ Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
² Department of Urology, Division of Pediatric Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
³ Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

PMID: 33205852
DOI: 10.1002/nau.24575

Abstract

Aims: To assess the efficacy of transcutaneous posterior tibial nerve stimulation (TPTNS) on functional voiding disorder (FVD) and investigate the utility of urine biomarkers (UBs: nerve growth factor, transforming growth factor-beta 1, and tissue inhibitor of metalloproteinases 2) in diagnosis and follow-up.

Methods: A total of 44 children were included to this randomized controlled trial prospectively. After randomization, 20 of 30 children with storage phase dysfunction those were unresponsive or noncompliant to medical treatment received TPTNS treatment (test group) and 10 children underwent TPTNS with no current (sham group) for 12 weeks. Fourteen healthy children constituted the nonsymptomatic group. UB levels, dysfunctional voiding and incontinence scoring system (DVISS), voiding diary, and quality of life (QoL) scores were assessed before and after treatment in the treatment groups.

Results: QoL scores, overall and day-time DVISS scores were significantly decreased in both sham and test groups (p < 0.05). In addition to these findings, the frequency of incontinence and urgency episodes were also significantly reduced (p < 0.05) in the TPTNS treatment group. This effect in the test group was still valid 2 years after intervention. There was no significant difference in UBs measurements between treatment and nonsymptomatic groups and between pretreatment and posttreatment measurements of test and sham groups.

Conclusions: TPTNS is an efficient minimally invasive treatment in children with FVD who do not respond to medical treatment. TPTNS provides a significant improvement on episodes of frequency, episodes of incontinence, overall and day-time DVISS scores, and QoL scores. The effectiveness of treatment continues even at the end of the second year of intervention. UBs were not found to be predictive in terms of diagnosis and evaluating the treatment response.

Keywords: children; functional voiding disorder; nerve growth factor; tissue inhibitor of metalloproteinases 2; transcutaneous posterior tibial nerve stimulation; transforming growth factor-beta 1; urine biomarkers.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Female
Humans
Male
Tibial Nerve / physiopathology*
Transcutaneous Electric Nerve Stimulation / methods*
Treatment Outcome
Urinary Incontinence / physiopathology
Urinary Incontinence / therapy*