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28
TH
CONGRESS OF THE ESPU
S20: FUNCTIONAL VOIDING
DISORDERS
Moderators: Marcos Giannetti Machado (Brazil), Guy Bogaert (Belgium)
ESPU Meeting on Saturday 22, April 2017, 08:10–09:12
08:10–08:15
S20-1 (LO)
★
COMBINING TRANSCUTANEOUS ELECTRICAL NERVE
STIMULATION (TENS) WITH OXYBUTYNIN IS SUPERIOR
TO MONOTHERAPY IN CHILDREN WITH OVERACTIVE
BLADDER AND DAYTIME URINARY INCONTINENCE –
A RANDOMIZED, PLACEBO-CONTROLLED STUDY
Luise BORCH
1
, Søren HAGSTRØM
2
, Konstantinos KAMPERIS
1
, Cecilie
Voldum SIGGAARD
1
and Søren RITTIG
1
1) Aarhus University Hospital, Pediatrics, Aarhus N, DENMARK - 2) Aalborg University Hospital, Pediatrics, Aalborg,
DENMARK
PURPOSE
To evaluate if combination therapy with TENS and oxybutynin results in a superior treatment re-
sponse on childhood urge incontinence than monotherapy with the two modalities.
MATERIAL AND METHODS
In this double-blind, placebo-controlled study 51 children with urge incontinence (mean age 7.5 ±
1.6 years) were randomized into three treatment groups. Group 1: active TENS + active oxybutynin
(n = 18). Group 2: active TENS + placebo oxybutynin (n = 19). Group 3: active oxybutynin + placebo
TENS (n = 14). The children received active/placebo TENS over the sacral S2-S3 outflow for two
hours daily in combination with 5 mg x 2/day of active/placebo oxybutynin. The intervention period
was 10 weeks. Primary outcome was number of wet days/week. Secondary outcomes were sever-
ity of incontinence, frequency, MVV/EBC, AVV/EBC and VAS score.
RESULTS
We found that active combination therapy was superior to oxybutynin monotherapy (P=0.05) with
an 83% greater chance of response in children receiving combination therapy. Active TENS/active
oxybutynin was also significantly more effective compared to active TENS monotherapy regarding
improvement in number of wet days/week (mean difference = -2.28, [CI: -4.06; -0.49]), severity of
incontinence (mean difference = -3.11, [CI: -5.98; -0.23]), and voiding frequency per day (mean
difference = -2.82, [CI: -4.48; -1.17]).
CONCLUSIONS
TENS in combination with oxybutynin for urge incontinence in children was shown to be superior
to both TENS and oxybutynin monotherapy although the latter only reached borderline statisti-
cal significance. Furthermore, TENS treatment was associated with a reduced risk of oxybutynin
induced post-void residual urine > 20 ml.