Anogenital electrical stimulation as treatment of urge incontinence in children

Objectives To evaluate retrospectively the result of anogenital afferent st imulation (AGAS) in neurological healthy children with therapy-resistant ur ge incontinence. Patients and method The study included 48 children (24 girls and 24 boys, 5 -14 years old) with a diagnosis of bladder instability verified by cystomet ry in all. Anogenital afferent stimulations were applied using a battery-po wered dual constant-current stimulator. The children were stimulated contin uously at 10 Hz for 20 min once or twice daily and if required the children and/or the parents continued to apply the treatment at home. For home stim ulation a single (anal) channel stimulator was used. The patients were inst ructed to stimulate for 20 min at maximum intensity two to three times a we ek until the effects were optimal. The outcome was evaluated retrospectivel y by comparing voiding/incontinence diaries obtained before and at the foll ow-up 6-12 months after the end of treatment. Results AGAS was applied at the clinic for a median (range) of 9 (4-20) tim es. Thirty-one children continued with home stimulation for another 25 (5-9 6) sessions. At the follow-up, 18 children were cured and another seven imp roved, with a leakage score of less than half that before treatment. The tr eatment was well tolerated by most children. Conclusions Anogenital afferent stimulation is an effective, potentially cu rative treatment in children with severe urge incontinence. Home stimulatio n is a well accepted adjuvant to treatment at the clinic and improves the o utcome.