The Effect of Electrical Nerve Stimulation in Management of Overactive Bladder in the Pediatric Population; A Systematic Review and Meta-Analysis

Background: In traditional medicine and recent years, nerve stimulation has been introduced as a replacement therapy for managing several disorders such as overactive bladder. However, there is still controversy in this regard. Therefore, the present meta-analysis aimed to assess the effectiveness of electrical nerve stimulation in treatment of overactive bladder. Methods: The present systematic review and meta-analysis attempted to gather the evidence existing in Medline, Embase, Scopus, Web of Sciences and CINHAL databases until the end of October 2017. Summarization of the articles was done by 2 independent researchers and finally, pooled effect size was reported as standardized mean difference (SMD) or overall odds ratio (OR) with 95% confidence interval (95% CI). In all analyses p<0.05 was considered as level of significance. Results: Data of 13 articles were entered. Analyses showed that using electrical nerve stimulation results in a significant decrease in wet days per week (SMD= -0.92; 95% CI: -1.47 to -0.37) and voiding frequency (SMD= -1.09; 95% CI: -2.15 to -0.03), and increase in maximum voided volume (SMD= 0.43; 95% CI: 0.13 to 0.73) and average voided volume (SMD= 0.78; 95% CI: 0.11 to 1.45). Finally, the success rate in the electrical nerve stimulation group was up to 2 times higher than the placebo or routine treatment group (odds ratio=2.11; 95% CI: 1.10 to 4.06; p=0.009). Conclusion: Since the findings of the present study indicate the effectiveness of electrical nerve stimulation in improvement of overactive bladder symptoms in children, it is suggested to use it in routine practice.