Electromagnetic stimulation for overactive bladder in myelomeningocele children: randomized controlled trial

Abstract

BACKGROUND: Myelomeningocele (MMC) is a congenital anomaly associated with neurological and urological complications, including overactive bladder. Overactive bladder is manifested by symptoms such as urgent and frequent urination, incontinence, and recurrent urinary tract infection, all of which can negatively affect children's quality of life. AIM: To investigate the efficacy of pulsed electromagnetic stimulation on overactive neurogenic bladder in MMC children. DESIGN: Randomized controlled trial. POPULATION: Forty children with MMC and overactive neurogenic bladder. METHODS: Children were recruited and allocated randomly into two groups of equal sizes; their ages ranged from four to twelve years. The sham PEMS group received standard anticholinergic medical treatment and sham pulsed electromagnetic stimulation for 20 minutes, while the real PEMS group received active pulsed electromagnetic stimulation (PEMS) for 20 minutes along with the same medical treatment as the sham group. For each group, treatment was delivered three times/week for three consecutive months. Urodynamic studies (UDS) were conducted, and daily scores for the frequency and severity of incontinence episodes were recorded. All the measured outcomes were evaluated at baseline and three months post-intervention. RESULTS: After treatment, UDS variables increased significantly in the real PEMS group compared to the sham PEMS group; detrusor leak point pressure increased, as did maximum cystometric capacity, expected maximum cystometric capacity, and first uninhibited detrusor contraction volume, while daily incontinence scores significantly decreased. CONCLUSIONS: Adding pulsed electromagnetic stimulation to conventional therapy was associated with controlling neurogenic overactive bladder in MMC children. CLINICAL REHABILITATION IMPACT: Pulsed electromagnetic stimulation has a notable effect on the neurogenic overactive bladder in MMC children.