REPLY BY THE AUTHORS: RE: Parasacral transcutaneous electrical nerve stimulation in children with overactive bladder: comparison between sessions administered two and three times weekly

To the editor,

We chose not to have a placebo group, as we and others have already demonstrated TENS is effective for OAB in children (¹-³). In our article, the main objective was to compare if the application of TENS 2 times a week could be as effective as TENS 3 times a week, since the frequency of TENS sessions is currently empirical (⁴). As in all the articles published by our group that involved TENS, the children received urotherapy. Therefore, the difference in outcome found between the groups concerns the action of TENS.

Regarding the article on TENS 2 versus 3 times a week, although the DVSS improved after treatment in both groups, there was no difference in the results of the inter-group evaluation. However, as pointed out in the letter to the Editor (⁵), voiding frequency improved in the bladder diary only in the TENS 2 times a week group. The interpretation, in this case, should not be that twice a week is better than 3 times, which does not make sense. But yes, it draws attention that data from the diary may not be reliable due to the measurement bias and that there may have been a spurious association. There were no intergroup differences in relation to the diary.

Evaluating the effect size for each group separately, we verified a moderate effect size, demonstrating once again that the response was similar between them (TENS 3x/w: Cohen's d- 1.83, size of effect: 0.87; TENS 2x/w: Cohen's d-1.73, size of effect- 0.65).

The Authors

REFERENCES

• ¹
  Borch L, Hagstroem S, Kamperis K, Siggaard CV, Rittig S. Transcutaneous Electrical Nerve Stimulation Combined with Oxybutynin is Superior to Monotherapy in Children with Urge Incontinence: A Randomized, Placebo Controlled Study. J Urol. 2017;198:430-5.
• ²
  Lordêlo P, Teles A, Veiga ML, Correia LC, Barroso U Jr. Transcutaneous electrical nerve stimulation in children with overactive bladder: a randomized clinical trial. J Urol. 2010;184:683-9.
• ³
  Jørgensen CS, Kamperis K, Borch L, Borg B, Rittig S. Transcutaneous Electrical Nerve Stimulation in Children with Monosymptomatic Nocturnal Enuresis: A Randomized, Double-Blind, Placebo Controlled Study. J Urol. 2017;198:687-93.
• ⁴
  Veiga ML, Oliveira K, Batista V, Nacif A, Braga AAM, Barroso U Jr. Parasacral transcutaneous electrical nerve stimulation in children with overactive bladder: comparison between sessions administered two and three times weekly. Int Braz J Urol. 2021;47:787-93.
• ⁵
  Lopes JM, Marinho EMS, Nunes R. RE: Parasacral transcutaneous electrical nerve stimulation in children with overactive bladder: comparison between sessions administered two and three times weekly. Int Braz J Urol. 2021; 47:1074-6.

Publication Dates

• Publication in this collection
  30 July 2021
• Date of issue
  Sep-Oct 2021

History

• Received
  28 May 2021
• Accepted
  31 May 2021
• Published
  03 June 2021