Experience of Intravesical Electrical Stimulation Therapy in Children with Enuresis

Lee, Seung Hoon; Hong, Chang Hee; Han, Sang Won

Abstract

PURPOSE: We investigated the therapeutic effect of intravesical electrical stimulation (IVES) in enuretic children who showed refractory response to drug therapy, on the basis that IVES induces direct activation of bladder A delta mechanoreceptor afferents which would result in modulation of a central micturition reflex.
MATERIALS AND METHODS
Of 351 enuretic children, the 22 who showed refractory response to drug monotherapy or combination therapy were enrolled in a clinical trial with IVES and then the therapeutic results of IVES and Post-IVES additional drug therapy were evaluated. Therapeutic response was defined when the frequency of bed-wetting was reduced by more than 50%.
RESULTS
The rates of therapeutic response to IVES and Post-IVES additional drug therapy were 63.6% and 89.5%, respectively. As compared with Pre-IVES drug therapy, IVES and Post-IVES additional drug therapy showed significant therapeutic effect (p<0.05). Factors such as sex, depth of sleep, attention insufficiency, family history, voiding pattern, frequency of IVES procedure, fecal symptoms and day-time voiding symptoms had no significant impact on therapeutic response to IVES in enuresis (p>0.05). However, there was significant reduction of bed-wetting after IVES in cases with improved day-time voiding symptoms after IVES (p=0.031).
CONCLUSIONS
In either a case of enuresis which shows refractory response to drug therapy as a primary modality of treatment or a case of complicated enuresis, IVES and Post-IVES additional drug therapy may produce a therapeutic response.