Pelvic floor electrical stimulation and muscles training: a combined rehabilitative approach for management of non-neuropathic urinary incontinence in children

J Pediatr Surg. 2019 Apr;54(4):825-830. doi: 10.1016/j.jpedsurg.2018.06.007. Epub 2018 Jun 11.


Purpose: To assess the efficacy of combined transcutaneous interferential (IF) electrical stimulation and pelvic floor muscle training through biofeedback on non-neuropathic urinary incontinence in children.

Methods: This prospective study comprised of 46 anatomically and neurologically normal children (9 boys, 37 girls; mean age of 8.4 ± 2.2 years old) with non-neuropathic urinary incontinence. All children were evaluated by kidney and bladder ultrasounds, uroflowmetry with electromyography (EMG), a complete voiding diary and a dysfunctional voiding scoring questionnaire at the baseline. Children were randomly allocated into two treatment groups including group A (n = 23) who underwent biofeedback therapy in addition to IF electrical stimulation and group B (n = 23) who received only biofeedback therapy. Re-evaluation was performed 6 months and one year after completion of the treatment sessions.

Results: Improvement of non-neuropathic urinary incontinence was significantly higher in group A in comparison to group B at two follow ups (P < 0.05). Daytime incontinence was improved in 19/23(82%) and 13/23(56.5%) of children in groups A and B respectively after the treatment (P < 0.01). There was no significant difference in uroflowmetry measures between two groups after the treatment.

Conclusions: Combination of biofeedback therapy and transcutaneous IF electrical stimulation is a potential effective modality in treating non-neuropathic urinary incontinence in children.

Level of evidence: Type of study: Treatment study. Level I: Randomized controlled trials with adequate statistical power to detect differences (narrow confidence intervals) and follow up >80%.

Keywords: Biofeedback; Children; Dysfunctional voiding; Electrical stimulation; Urinary incontinence.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Biofeedback, Psychology / methods*
  • Child
  • Combined Modality Therapy
  • Electromyography
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pelvic Floor / physiopathology*
  • Prospective Studies
  • Surveys and Questionnaires
  • Transcutaneous Electric Nerve Stimulation / methods*
  • Treatment Outcome
  • Urinary Bladder Diseases / physiopathology
  • Urinary Incontinence / therapy*