Suprapubic Magnetic Stimulation (SMS) by Arm type Magnetic Stimulator in Children with Neurogenic Detrusor Overactivity

Tack Lee, M.D., PhD, Jin-Kwan Jung, M.D. Young-Min Kim,

Department of Urology, Inha University Hospital, Incheon, Korea

 

Objective

The use of electric current has been written much as an adjunctive treatment for the neurogenic bladder dysfunction in adults. Because they need this bladder management for the rest of their life, the less invasive methods such as magnetic stimulation are needed today especially in children. Thus,

We evaluated the effect of Suprapubic Magnetic stimulator for treatment of children with neurogenic detrusor overactivity.

 

Materials and methods

In a prospective study, 6 patients ( 2boys, 4girls ) with mean age of 9.7±3.6 (4 to 14 ) years, who had

neurogenic detrusor overactivity underwent total 16 sessions (10 Hz, 10 KGauss, 50-100%, 20 min a session, 2 sessions a week ) of SMS by a newly developed arm type high-field magnetic stimulator ( BioCon-1000, Mcube, Korea ). They had neurogenic detrusor overactivity due to meningomyelocele(2), or cerebral palsy (2), sacra agenesis (2). This study was approved by the ethic committee of Inha University Hospital. Patient enrolled in this study were required to be off all medication for a minimum of 1week. Urodynamic studies, detailed frequency/volume chart, Selected items of Korean I-QoL revised were completed before and after the study (8 week). Subjective success was defined as the request to continue treatment, whereas objective success was defined as a significant reduction ( to < 50% ) in total number of leakage episodes and voiding frequency during daytime and enuretic episodes during sleep. Student’s t test was used to compare paired values.

Results

Of the 6 patients, five patients (83.3%) wanted to continue this treatment periodically (subjective success). All patients (100.0%) showed signigicant reductions (to<50%) in voiding frequency, incontinence episodes, and enuretic events (objective success). Quality of life parameters improved in all patients. On urodynamic finding, mean first involuntary detrusor contraction volume and mean maximum cystometric capacity increased (Table 1).

All patients underwent without any significant discomfort. Additionally 3 children remarked increased defecation sense during consecutive magnetic stimulation.

Conclusion

Our results suggest that SMS by arm type high-field magnetic stimulator produced signigicant changes in presenting symptoms and urodynamic parameters in children with neurogenic detrusor overactivity. And this therapy is attractive for children because of its noninvasiveness and absence of adverse effects. In the future, this therapy can be applied to more cases with neurogenic detrusor overactivity or other disorders such as retractory nocturnal enuresis or non-neurogenic lower urinary tract dysfunctions.