ESPU Congress 2017 - Abstract book

229

19–22 APRIL, 2017, BARCELONA, SPAIN

08:51–08:54

S20-10 (PP)

PERCUTANEOUS PARASACRAL NEUROMODULATION

FOR OVERACTIVE BLADDER IN CHILDREN – A PILOT

STUDY

Ubirajara BARROSO

, Alan AZEVEDO

, Mariana CABRAL

, Ana Aparecida BRAGA

Maria Luiza VEIGA

and José Murillo NETTO

1) Federal University of Bahia and Bahiana School of Medicine, Pediatric Urology, Salvador, BRAZIL - 2) Bahiana

School of Medicine, Pediatric Urology, Salvador, BRAZIL - 3) Bahiana School of Medicine, Psychology, Salvador,

BRAZIL - 4) Bahiana School of Medicine, Physiotherapy, Salvador, BRAZIL - 5) Federal University of Juiz de Fora,

Urology, Juiz De Fora, BRAZIL

PURPOSE

We developed a method of neuromodulation for OAB in children that consist of a percutaneous

parasacral electrical stimulation by an introduction of an acupuncture needle. The theoretical ad-

vantage of this method is to pass the skin that have a high impedance (decreasing the resistance

to the current) and to get closer to S3 where our target nerves are. The aim of this studies to report

our beginning experience.

MATERIAL AND METHODS

This is a prospective study of 15 patients with pure OAB, meaning that the patients had urgency

and low postvoid residual urine (less than 10% of the expected bladder capacity for age) and a bell

or tower shaped uroflow curve.

Two needles were placed simetrically in the sacral area, 2 fingers below a posterior line crossing

the anterosuperior iliac crist and 2 fingers away of the midline (figure). Patients underwent 6 months

of sessions once a week, for 30 minutes. The frequency of current used was 10 Hz. Outcome was

evaluated by VAS and DVSS.

RESULTS

Results

We followed 15 children, being 6 boys and 9 girls. The mean age was 7.5 years. The distribution of

symptoms before and after percutaneous parasacral neuromodulation (PPN) is shown in the table.

After treatment VAS scored 10 (complete resolution of the symptoms) in ten patients, 9 in two,

8 in two and 6 in one. Urgency (p=0.003), daytime incontinence (p=0.001), frequency (p=0.004),

enuresis (p=0.016) and DVSS (p=0.002) improved significantly after treatment.

CONCLUSIONS

Percutaneous parasacral neuromodulation (PPN) once a week has shown to be effective in this

small number of children with OAB. We believe that by decreasing the skin resistance against

the current and getting closer to S3 may make this method useful even being used once a week.

A large number of patients, longer follow up, and a control group are necessary to better study the

real efficacy of this procedure.

08:54–09:12

Discussion