J Pediatr Urol. 2025 Sep 16:S1477-5131(25)00486-3. doi: 10.1016/j.jpurol.2025.09.012. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) in the management of overactive bladder (OAB) in children by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).
METHODS: A systematic search of PubMed, Embase and the Cochrane Library was conducted to identify RCTs comparing TENS with standard therapies (urotherapy, sham TENS, or oxybutynin) in children with OAB. Inclusion criteria encompassed RCTs published between 2004 and 2024, reporting TENS as a primary intervention. Data were pooled using a meta-analysis framework, and heterogeneity was assessed using I2 statistics. Risk of bias was evaluated using the ROBVIS tool.
RESULTS: Nine RCTs involving 382 children were included. Five studies compared active TENS with sham TENS, of which three reported superior efficacy for TENS, while two found no difference. Two studies compared TENS with oxybutynin; one demonstrated TENS superiority, while the other found comparable efficacy. One study showed TENS to be as effective as urotherapy, and another found that TENS combined with oxybutynin was superior to either treatment alone. The meta-analysis revealed that TENS significantly increased the likelihood of a full response compared to other treatments (OR 3.96, 95 % CI 2.46-6.38, p < 0.001). TENS was effective both as a standalone therapy (OR 4.34) and as an adjunct (OR 3.27). Parasacral TENS demonstrated a higher response rate than posterior tibial TENS.
CONCLUSION: TENS is an effective, non-invasive therapy for pediatric OAB, either as monotherapy or in combination with urotherapy or medication. However, variability in study protocols and limited long-term follow-up data highlight the need for standardized treatment protocols and larger RCTs to assess long-term outcomes, including relapse rates.
PROSPERO REGISTRATION NUMBER: CRD420251114932.
PMID:41016899 | DOI:10.1016/j.jpurol.2025.09.012
