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Medline ® Abstract for Reference 61

of 'Management of bladder dysfunction in children'

Anogenital electrical stimulation as treatment of urge incontinence in children.
Gladh G, Mattsson S, Lindström S
BJU Int. 2001;87(4):366.
OBJECTIVES: To evaluate retrospectively the result of anogenital afferent stimulation (AGAS) in neurological healthy children with therapy-resistant urge incontinence.
PATIENTS AND METHODS: The study included 48 children (24 girls and 24 boys, 5-14 years old) with a diagnosis of bladder instability verified by cystometry in all. Anogenital afferent stimulations were applied using a battery-powered dual constant-current stimulator. The children were stimulated continuously at 10 Hz for 20 min once or twice daily and if required the children and/or the parents continued to apply the treatment at home. For home stimulation a single (anal) channel stimulator was used. The patients were instructed to stimulate for 20 min at maximum intensity two to three times a week until the effects were optimal. The outcome was evaluated retrospectively by comparing voiding/incontinence diaries obtained before and at the follow-up 6-12 months after the end of treatment.
RESULTS: AGAS was applied at the clinic for a median (range) of 9 (4-20) times. Thirty-one children continued with home stimulation for another 25 (5-96) sessions. At the follow-up, 18 children were cured and another seven improved, with a leakage score of less than half that before treatment. The treatment was well tolerated by most children.
CONCLUSIONS: Anogenital afferent stimulation is an effective, potentially curative treatment in children with severe urge incontinence. Home stimulation is a well accepted adjuvant to treatment at the clinic and improves the outcome.
Department of Health and Environment, Division of Paediatrics, Faculty of Health Sciences, Linköping, Sweden. gunilla.gladh@lio.se