Transurethral intravesical electrotherapy for neurogenic bladder dysfunction in children with myelodysplasia: A prospective, randomized clinical trial

T. B. Boone, Claus Roehrborn, G. Hurt

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Myelomeningocele is the most common cause of neurogenic bladder dysfunction in children. Urinary incontinence is socially disabling for many of these children and undetected elevations in detrusor pressure can lead to serious upper tract damage. Sensory receptors in the bladder mucosa and submucosa provide afferent information to the central nervous system regulating the micturition reflex. Since 1959 Katona and several other investigators have used intravesical electrotherapy for diagnosis and treatment of the neuropathic bladder. Our objective was to conduct a randomized, sham controlled and blinded clinical study on the efficacy of transurethral intravesical electrotherapy in treating urinary incontinence in the myelodysplastic child. A total of 36 children was enrolled in the study and 31 completed the entire protocol. Of the patients completing the study 13 were randomly selected to serve as an internal sham control having the electrocatheter placed without activating the stimulator. These patients were subsequently treated with a 3-week course of electrotherapy. The remaining 18 patients completing the study were randomly selected to undergo 2, 3-week courses of intravesical bladder stimulation. Urodynamic studies were performed before and after each treatment series. Detailed daily questionnaires were submitted to each participant covering subjective improvement in urinary continence and any development of bladder sensory awareness. Analysis of the urodynamic data and questionnaires failed to reveal any statistically significant increase in bladder capacity, development of detrusor contractions, improvement in detrusor compliance or the acquisition of bladder sensation allowing timely intermittent catheterization preventing urinary incontinence.

Original languageEnglish (US)
Pages (from-to)550-554
Number of pages5
JournalJournal of Urology
Volume148
Issue number2 II
StatePublished - 1992

Fingerprint

Electric Stimulation Therapy
Neurogenic Urinary Bladder
Urinary Bladder
Randomized Controlled Trials
Urinary Incontinence
Urodynamics
Meningomyelocele
Urination
Sensory Receptor Cells
Catheterization
Compliance
Reflex
Mucous Membrane
Central Nervous System
Research Personnel
Pressure
Therapeutics

Keywords

  • bladder
  • electric stimulation
  • neural tubal defects
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

@article{fefbd4ffc62c45c49df88ffe406bf5ac,
title = "Transurethral intravesical electrotherapy for neurogenic bladder dysfunction in children with myelodysplasia: A prospective, randomized clinical trial",
abstract = "Myelomeningocele is the most common cause of neurogenic bladder dysfunction in children. Urinary incontinence is socially disabling for many of these children and undetected elevations in detrusor pressure can lead to serious upper tract damage. Sensory receptors in the bladder mucosa and submucosa provide afferent information to the central nervous system regulating the micturition reflex. Since 1959 Katona and several other investigators have used intravesical electrotherapy for diagnosis and treatment of the neuropathic bladder. Our objective was to conduct a randomized, sham controlled and blinded clinical study on the efficacy of transurethral intravesical electrotherapy in treating urinary incontinence in the myelodysplastic child. A total of 36 children was enrolled in the study and 31 completed the entire protocol. Of the patients completing the study 13 were randomly selected to serve as an internal sham control having the electrocatheter placed without activating the stimulator. These patients were subsequently treated with a 3-week course of electrotherapy. The remaining 18 patients completing the study were randomly selected to undergo 2, 3-week courses of intravesical bladder stimulation. Urodynamic studies were performed before and after each treatment series. Detailed daily questionnaires were submitted to each participant covering subjective improvement in urinary continence and any development of bladder sensory awareness. Analysis of the urodynamic data and questionnaires failed to reveal any statistically significant increase in bladder capacity, development of detrusor contractions, improvement in detrusor compliance or the acquisition of bladder sensation allowing timely intermittent catheterization preventing urinary incontinence.",
keywords = "bladder, electric stimulation, neural tubal defects, urinary incontinence",
author = "Boone, {T. B.} and Claus Roehrborn and G. Hurt",
year = "1992",
language = "English (US)",
volume = "148",
pages = "550--554",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2 II",

}

TY - JOUR

T1 - Transurethral intravesical electrotherapy for neurogenic bladder dysfunction in children with myelodysplasia

T2 - A prospective, randomized clinical trial

AU - Boone, T. B.

AU - Roehrborn, Claus

AU - Hurt, G.

PY - 1992

Y1 - 1992

N2 - Myelomeningocele is the most common cause of neurogenic bladder dysfunction in children. Urinary incontinence is socially disabling for many of these children and undetected elevations in detrusor pressure can lead to serious upper tract damage. Sensory receptors in the bladder mucosa and submucosa provide afferent information to the central nervous system regulating the micturition reflex. Since 1959 Katona and several other investigators have used intravesical electrotherapy for diagnosis and treatment of the neuropathic bladder. Our objective was to conduct a randomized, sham controlled and blinded clinical study on the efficacy of transurethral intravesical electrotherapy in treating urinary incontinence in the myelodysplastic child. A total of 36 children was enrolled in the study and 31 completed the entire protocol. Of the patients completing the study 13 were randomly selected to serve as an internal sham control having the electrocatheter placed without activating the stimulator. These patients were subsequently treated with a 3-week course of electrotherapy. The remaining 18 patients completing the study were randomly selected to undergo 2, 3-week courses of intravesical bladder stimulation. Urodynamic studies were performed before and after each treatment series. Detailed daily questionnaires were submitted to each participant covering subjective improvement in urinary continence and any development of bladder sensory awareness. Analysis of the urodynamic data and questionnaires failed to reveal any statistically significant increase in bladder capacity, development of detrusor contractions, improvement in detrusor compliance or the acquisition of bladder sensation allowing timely intermittent catheterization preventing urinary incontinence.

AB - Myelomeningocele is the most common cause of neurogenic bladder dysfunction in children. Urinary incontinence is socially disabling for many of these children and undetected elevations in detrusor pressure can lead to serious upper tract damage. Sensory receptors in the bladder mucosa and submucosa provide afferent information to the central nervous system regulating the micturition reflex. Since 1959 Katona and several other investigators have used intravesical electrotherapy for diagnosis and treatment of the neuropathic bladder. Our objective was to conduct a randomized, sham controlled and blinded clinical study on the efficacy of transurethral intravesical electrotherapy in treating urinary incontinence in the myelodysplastic child. A total of 36 children was enrolled in the study and 31 completed the entire protocol. Of the patients completing the study 13 were randomly selected to serve as an internal sham control having the electrocatheter placed without activating the stimulator. These patients were subsequently treated with a 3-week course of electrotherapy. The remaining 18 patients completing the study were randomly selected to undergo 2, 3-week courses of intravesical bladder stimulation. Urodynamic studies were performed before and after each treatment series. Detailed daily questionnaires were submitted to each participant covering subjective improvement in urinary continence and any development of bladder sensory awareness. Analysis of the urodynamic data and questionnaires failed to reveal any statistically significant increase in bladder capacity, development of detrusor contractions, improvement in detrusor compliance or the acquisition of bladder sensation allowing timely intermittent catheterization preventing urinary incontinence.

KW - bladder

KW - electric stimulation

KW - neural tubal defects

KW - urinary incontinence

UR - http://www.scopus.com/inward/record.url?scp=0026693673&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026693673&partnerID=8YFLogxK

M3 - Article

C2 - 1640520

AN - SCOPUS:0026693673

VL - 148

SP - 550

EP - 554

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2 II

ER -