A study of the effects of home administered transcutaneous electrical nerve stimulation on quality of life, psychosocial and incontinence outcomes in children with overactive bladder syndrome

Abstract

Main problem. There is uncertainty about the effect of transcutaneous electrical nerve stimulation on quality of life and psychosocial outcomes in children with lower urinary tract symptoms. We aim to describe its impact on quality of life, psychosocial outcomes and lower urinary tract symptoms in Australian children with overactive bladder while exploring the role of confounders including baseline co-morbidities and length of transcutaneous electrical nerve stimulation usage at home. Methods. Children aged four to 18 years with symptoms of overactive bladder were given a transcutaneous electrical nerve stimulation machine for use at home. Data was collected at baseline and again three months later using a modified Paediatric Incontinence Quality of life Questionnaire, Strengths and Difficulties Questionnaire and an Incontinence Questionnaire and compared using paired t-tests. Separate analysis by gender, lower urinary tract symptoms and comorbidities was conducted. Results. Thirty-one children (15 girls) aged six to 16 years enrolled. The mean change in total Quality of Life Questionnaire score from baseline to post-treatment was -0.2 (95%CI-0.5 to 0.1; p=0.1), change in total Strengths and Difficulty Questionnaire score was -0.1 (95%CI-1.5 to 1.2; p=0.8) and change in total Incontinence Questionnaire score was -1.9 (95%CI-2.9 to -1.0; p=0.0004). Five participants who were positive for lower urinary tract symptoms at baseline became negative post treatment, whereas no participants without symptoms at baseline became positive post-treatment (p=0.025). Conclusions. Transcutaneous electrical nerve stimulation monotherapy administered at home is potentially an effective treatment option for children with overactive bladder without adversely affecting their quality of life and psychosocial wellbeing.