Int Neurourol J.  2018 Dec;22(4):295-304. 10.5213/inj.1836142.071.

Effectiveness of Intra-anal Biofeedback and Electrical Stimulation in the Treatment of Children With Refractory Monosymptomatic Nocturnal Enuresis: A Comparative Randomized Controlled Trial

• Abd El-Moghny SM
• El-Din MS
• El Shemy S

• KMID: 2431871
• DOI: http://doi.org/10.5213/inj.1836142.071

Abstract

PURPOSE
To compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE).
METHODS
Ninety children of both sexes aged 8-12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment.
RESULTS
After training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups.
CONCLUSIONS
Both intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.

Keyword

Electromyography biofeedback; Electrical stimulation; Refractory monosymptomatic nocturnal enuresis

MeSH Terms

Biofeedback, Psychology*
Child*
Electric Stimulation*
Electromyography
Humans
Muscles
Nocturnal Enuresis*
Pelvic Floor
Urinary Bladder