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G404(P) Transcutaneous Electrical Nerve Stimulation for the treatment for bladder overactivity in Paediatric patients resistant or intolerant to anti-cholinergic medication
  1. E Moore,
  2. A Wright,
  3. J Clothier
  1. Department of Paediatric Nephrology and Urology, Evelina London Children’s Hospital, London, UK

Abstract

Aims To describe our single centre experience of the use of transcutaneous electrical nerve stimulation (TENS) as a form of neuromodulation for the treatment of bladder over activity (OAB) in children resistant or intolerant to anti-cholinergic therapy.

Methods All patients over the age of 5 years with a diagnosis of OAB who were found to be anti-cholinergic intolerant or resistant (following treatment with ≥2 anti-cholinergic medications) were offered TENS therapy. All patients had been given a diagnosis of OAB following bladder clinic consultation, completed bladder diaries and assessment with 3 voids on the uroflow with post void ultrasound. All were individually shown how to use the TENS machine and were commenced on a 3 month program involving, daily 40-60 min therapy at home. Treatment diaries were given with review organised at the end of 3 months of treatment.

Results 42 children received treatment between July 2012 and October 2013. 67% female. Median age 11 years (range 6–17 years). 90% were resistant to anti-cholinergic treatment, with 7 previously receiving intra-vesical botulinum toxin injection for OAB.

Cure of symptoms was achieved in 21%, improvement in symptoms seen in 43%, 31% had no response, 1 did not commence therapy due to discomfort and 1 lost to follow up. 88% found the treatment acceptable, 2 patients described discomfort, 2 received shocks and 1 found treatment too time consuming.

Conclusions TENS offers a well tolerated and effective treatment option for children with anti-cholinergic resistant/intolerant OAB. Large randomised studies are required to determine the population this treatment benefits the most and longer follow-up required to determine if improvement is sustained once treatment is discontinued.

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