Electrical stimulation, muscle exercises work in kids with bladder bowel dysfunction

Children with bladder bowel dysfunction (BBD) fare well with combined pelvic floor interferential (IF) electrical stimulation and muscle exercises, which can lead to a significant decrease in daytime incontinence, urgency, and constipation, as shown in a study.

A total of 34 children with BBD (mean age, 7.4 years; 28 girls) were randomized to undergo pelvic floor muscle (PFM) exercises alone (n=17) or in combination with transcutaneous IF electrical stimulation (n=17) for 10 sessions. The exercises consisted of contraction of the PFM for 10 seconds followed by 30 seconds of relaxation, abdominal straining, and bear-down manoeuvre. On the other hand, electrical stimulation lasted 20 minutes per session.

Evaluations included kidney and bladder ultrasounds, uroflowmetry plus electromyography (EMG), and a complete voiding and bowel habit diary.

At treatment conclusion, constipation improved in significantly more children in the combination group than in the exercise group (82 percent vs 47 percent; p=0.03). Mean defecation frequency per week increased from 2.7 to 5.8 and from 2.7 to 4.5 in the respective groups (p<0.04).

Combination treatment also led to more patients achieving improvements in daytime incontinence (100 percent vs 25 percent; p=0.007) and urinary tract infection (80 percent vs 38.4 percent; p=0.02) compared with exercise alone.

There was no significant difference seen in uroflowmetry measures after the treatment.