Noninvasive neuromodulation effectively treats pediatric overactive bladder

By Reuters Staff

NEW YORK (Reuters Health) - Transcutaneous posterior tibial nerve stimulation (PTNS) is an effective treatment for non-neurogenic overactive bladder (OAB) in pediatric patients, according to a recent study conducted in India.

Traditional treatments for non-neurogenic OAB in children include behavioral therapy, bladder training and anticholinergic drugs. However, at least 20% of children do not respond to these therapies, according to the authors of this new study published online July 29 in the Journal of Pediatric Urology.

Dr. Nitesh Patidar and colleagues at the Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, India, conducted a placebo-controlled randomized trial of 40 children with non-neurogenic OAB, refractory to anticholinergic drugs and behavioral therapy, to determine if PTNS was an effective and acceptable therapy.

Neuromodulation was conducted in 30-minute sessions, once a week, for 12 weeks.

After treatment, 71.4% of the children in the treatment group reported no incontinence and 23.8% reported only mild incontinence, while in the placebo group only 12.5% of participants reported no incontinence.

The treatment group also experienced significant improvements in average voided volume, maximum voided volume, and number of voids compared with the placebo group (p<0.001).

"The results of this study provide strong evidence that the therapeutic effect of PTNS is due to the stimulation of the posterior tibial nerve and is not due to a placebo effect," the researchers wrote.

The researchers point out that although the mechanism of action of neuromodulation is still unknown, "the idea of stimulating the tibial nerve was based on traditional Chinese acupuncture using points over peroneal or posterior tibial nerves to inhibit bladder activity."

The authors of the study did not respond to requests for comment by press time.

SOURCE: http://bit.ly/1DpOlBR

J Pediatr Urol 2015.

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