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

• Published in: International neurourology journal Vol. 22; no. 4; pp. 295 - 304
• Main Authors: Abd El-Moghny, Seham Mohammed, El-Din, Manal Salah, El Shemy, Samah Attia
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Continence Society 01.12.2018; 대한배뇨장애요실금학회
• Subjects: Electrical stimulation; Electromyography biofeedback; Original; Refractory monosymptomatic nocturnal enuresis; 비뇨기과학; Electrical stimulation; Refractory monosymptomatic nocturnal enuresis; Electromyography biofeedback
• ISSN: 2093-4777; 2093-6931; 2093-6931
• DOI: 10.5213/inj.1836142.071

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). 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. 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. 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.