ESPU Congress 2017 - Abstract book

235

19–22 APRIL, 2017, BARCELONA, SPAIN

09:23–09:26

S21-4 (PP)

NEUROSTIMULATION THERAPY FOR PEDIATRIC PRIMARY

NOCTURNAL ENURESIS (PNE): A META-ANALYSIS

Roberto IGLESIAS LOPES

, Michael CHUA

, Jose Nicolas FERNANDEZ

Jessica MING

, Jan Michael SILANGCRUZ

, Armando Jose LORENZO

Martin Allan KOYLE

and Joana DOS SANTOS

1) The Hospital for Sick Children, University of Toronto, Division of Urology, Department of Surgery, Toronto, CANADA -

2) St Luke’s Medical Center, Division of Urology, Department of Surgery, Quezon City, PHILIPPINES

PURPOSE

We herein assessed the efficacy of neurostimulation compared to control groups in the treatment

of pediatric enuresis. We aim to determine treatment response, as defined by the International

Children’s Continence Society, mean number of wet-night per week reduction and adverse events,

by meta-analysis of randomized controlled trials (RCTs).

MATERIAL AND METHODS

A systematic literature search was done on August 2016 in Pubmed, Scopus, Embase, Cochrane

and Wiley Libraries, clinicaltrials.gov and WHO-International Clinical Trials Registry Platform. RCTs

were identified and evaluated according to the Cochrane Collaboration risk of bias assessment

recommendations. The number of patients with post-treatment partial /PR (50%-89%), complete/

CR (>90%) and full / FR(100%) responses were extracted for relative risk (RR) and 95% con-

fidence interval (CI). The mean numbers of wet-night reductions per week from each treatment

group were extrapolated as mean difference (MD) and 95%CI. Effect estimates were pooled using

Mantel-Haenszel method and inverse variance with fixed effect model when heterogeneity was not

significant (p>0.1).

RESULTS

272 subjects (6 RCTs) were included. Pooled effect estimate of subjects with>50% post-treatment

wet-night reduction (PR, CR & FR) showed a significantly better outcome for neurostimulation

compared to controls (RR=2.07, 95%CI 1.58, 2.72). Patients with>90% post-treatment wet night

reduction (CR & FR) showed a significantly better outcome in the neurostimulation group (RR=2.70,

95%CI 1.48, 4.93). A significant mean difference in wet-night reduction per week was noted with

neurostimulation (MD-2.30, 95%CI -3.35, -1.25). No serious adverse effects were observed.

CONCLUSIONS

Current evidence shows neurostimulation is efficacious and safe for pediatric PNE management.

09:26–09:40

Discussion