骶旁经皮神经电刺激疗法难治性膀胱过度活动症儿童和青少年的治疗。

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY
Carlos Eduardo Rocha Macedo, Antônio Vitor Nascimento Martinelli Braga, Felipe Santos Marimpietri, Beatriz Paixão Argollo, Glicia Estevam de Abreu, Maria Luiza Veiga da Fonseca, Ana Aparecida Nascimento Martinelli Braga, Ubirajara Barroso
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引用次数: 0

摘要

背景:尽管骶旁TENS(pTENS)已在多个中心使用,但缺乏对膀胱过度活动症(OAB)患儿在未能完成pTENS疗程后如何应对的研究。本研究旨在描述和评估对 pTENS 无效的膀胱过度活动症儿童的治疗方法:这项回顾性病例系列研究调查了 4-17 岁的患者。患者接受的后续治疗方案包括:行为疗法、奥昔布宁、丙咪嗪、奥昔布宁和丙咪嗪联合疗法、骶旁经皮电刺激(PENS)或重复 pTENS 疗程。结果采用排尿功能障碍评分系统(DVSS)和视觉模拟量表(VAS)进行评估:共纳入 30 名儿童,中位年龄为 7 岁。患者接受了一种或多种治疗。其中 70% 接受了单一疗法。其中,57%的患者症状完全缓解,28%的患者症状部分缓解并对治疗结果表示满意,14%的患者中断了治疗。在所有样本中,有 30% 的人继续感到症状困扰。根据最初的治疗结果,54%的患者获得了完全缓解:54%的患者接受了强化行为疗法,33%的患者接受了奥昔布宁疗法,50%的患者只接受了丙咪嗪疗法。DVSS评分中位数从7.0分降至2.0分(p=0.025),而VAS评分中位数从80分升至100分(p结论:接受结构化后续治疗的 pTENS 难治性 OAB 患儿在所有病例中均表现出部分反应,半数患者症状完全缓解。加强尿路治疗、药物治疗或结合奥昔布汀重复使用 pTENS 可以有效控制这种具有挑战性的病情。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation.

Background: Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not respond to pTENS.

Material and methods: This retrospective case series examined patients aged 4-17 years. Patients were given subsequent treatment options, including: behavioral therapies; oxybutynin; imipramine; a combination of oxybutynin and imipramine; parasacral percutaneous electrical nerve stimulation (PENS); or a repeat course of pTENS. Outcomes were evaluated using the Dysfunctional Voiding Scoring System (DVSS) and the Visual Analogue Scale (VAS).

Results: Thirty children were included, with a median age of 7 years. Patients received one or more treatments. Of these, 70% underwent monotherapy. Among them, 57% experienced complete resolution of symptoms, 28% had partial resolution and were satisfied with the results, and 14% discontinued treatment. 30% out of the whole sample continued to experience bothersome symptoms. Complete response, according to initial subsequent, was achieved in: 54% with intensified behavioral therapies, 33% with oxybutynin, and 50% with imipramine alone. The median DVSS score decreased from 7.0 to 2.0 (p=0.025), while the median VAS score increased from 80 to 100 (p<0.001).

Conclusion: Children with OAB refractory to pTENS who received structured subsequent treatments showed partial response in all cases, with complete symptom resolution in half of the patients. More intensive urotherapy, medications, or repeat pTENS in combination with oxybutinin can be effective for managing this challenging condition.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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