Transcutaneous Electrical Nerve Stimulation in Children with Nocturnal Enuresis: A Systematic Review
Kevin Gustavo dos Santos Silva1, Luana Dias da Silva1, Beatriz Santos Viana da Silva1, Iris Manz de Paula Ferreira1
1Anhembi Morumbi University
Objective:
The aim of this study is to systematically review the literature on the efficacy and safety of transcutaneous electrical nerve stimulation (TENS) in children with nocturnal enuresis.
Background:
Nocturnal enuresis is a common condition in childhood that can impact emotional well-being and family dynamics. Conventional treatments, including behavioral and pharmacological approaches, often show limited long-term success. Transcutaneous electrical nerve stimulation (TENS) has emerged as a non-invasive therapeutic alternative aimed at modulating bladder control through neural pathways.
Design/Methods:
The keywords “Nocturnal Enuresis,” “Transcutaneous Electric Nerve Stimulation,” and “Child,” were combined with the Boolean operator “AND,” were applied to the PubMed (Medline) and Lilacs databases, with filters for randomized clinical trials published in full within the last ten years.
Results:
Four randomized clinical trials were evaluated, totaling 230 children (N=230) aged 6 to 14 years, conducted in Egypt, Denmark, Iran, and Brazil. The interventions included different modalities of electrical stimulation, such as parasacral TENS, sacral TENS, and interferential current (IFC), in protocols of 15 to 20 sessions lasting 20 to 60 minutes, applied two to three times per week. Overall, the studies by Abdelhalim et al. (2019), Kajbafzadeh et al. (2015), and Oliveira LF et al. (2023) demonstrated a reduction in the frequency of enuretic episodes and improvement in quality of life, particularly with IFC, which showed greater efficacy and sustained effects. In contrast, Jorgensen et al. (2017) found no significant difference compared to placebo, with no cases of complete resolution. Nevertheless, the technique showed good tolerability, with minimal adverse events limited to mild skin irritation and headache in a few cases.
Conclusions:
TENS showed moderate efficacy in reducing nocturnal enuresis, though results varied with stimulation parameters and follow-up time. Limitations include small samples, heterogeneous protocols, and short follow-up. Larger, standardized trials with long-term evaluation are needed to better define its efficacy in children.
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