Eletroestimulação nervosa transcutânea parassacral associada à terapia comportamental versus terapia comportamental na enurese primária monossintomática: estudo clínico randomizado controlado

Abstract

Enuresis is characterized by nocturnal urinary incontinence and considered a disease after 5 years of age. The most common form of the disorder is monosymptomatic enuresis, when only nocturnal loss of urine is present. In non-monosymptomatic enuresis besides nocturnal loss of urine daytime lower urinary tract symptoms occur. It is believed that parassacral transcutaneous electrical neural stimulation (PTENS) has a physiological recondition effect redesigning synapses by neuronal plasticity. Its use in children with lower urinary tract dysfunction is well known, however, no study has evaluated its effects on monosymptomatic enuresis. Objectives: Evaluate the clinical response of PTENS in children with primary enuresis monosymptomatic comparing the behavioral treatment. Material and methods: 72 children were divided into two groups: CG (urotherapy and placebo electrical stimulation) and EG (urotherapy and ENTP). In both groups, 20 sessions were performed, three times a week, for twenty minutes each, with 10Hz of frequency, 700μS of pulse width and intensity determined by the patient. The percentages of dry nights 15 days before treatment (T0) were analyzed after the 20th session (T1), 15 (T2), 30 (T3), 60 (T4) and 90 (T5) days after the end of the sessions. Results: 20 children, 11 girls (55%) with a mean age of 9.09 ± 2.23 years completed the study. The groups were similar as for sex (p> 0.39). There was no difference in mean age between groups. Mean of the percentage of dry nights of EG at T0 was 39.8%, T1 at 53%, T2 at 58%, T3 at 59.2%, T4 at 58.2% and T5 at 63%, while in GC these percentages were 24.4%, 37.3%, 33.4%, 33.2% and 34%, respectively. The mean percentage of dry nights in the GC was 32.7% and in the GE 55.3% (p = 0.046). Conclusion: PTENS associated with behavioral therapy was shown to be effective in the treatment of monosymptomatic primary enuresis.