Neurostimulation therapy for non-neurogenic overactive bladder in children : a meta-analysis
Ver / Descargar
Fecha
2017Autor(es)
Fernández Bonilla, José NicolasChua, Michael E.
Ming, Jessica M.
Silangcruz, Jan Michael
Zu'bi, Fadi
Dos Santos, Joana
Lorenzo, Armando J.
Braga, Luis H.
Iglesias Lopes, Roberto
Autor(es) Corporativo(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Cirugía y Especialidades. Grupo de Investigación de Cirugía y Especialidades
Tipo
Artículo de revista
ISSN
0090-4295 / 1527-9995 (Electrónico)
Páginas
201-207
Compartir este registro
Citación
Documentos PDF
Abstract
Objective: To assess the efficacy and safety of neurostimulation for non-neurogenic overactive bladder in children, we conducted a meta-analysis of randomized controlled trials (RCTs).
Materials and methods: A systematic literature search was performed on August 2016. RCTs were evaluated according to the Cochrane Collaboration risk of bias assessment. Number of patients with post-treatment partial response (PR) (50%-89%), complete response (CR) (≥90%), and full response (FR) (100%) were extracted for relative risk (RR) and 95% confidence interval (CI). Effect estimates were pooled using the Mantel-Haenszel method with random effect model if significant inter-study heterogeneity (P <.1) was noted. Subgroup analysis was performed according to each treatment setting (PROSPERO CRD42016043502).
Results: Five eligible studies (245 patients) were included. Overall effect estimates showed that compared with standard urotherapy, neurostimulation demonstrated significantly better ≥50% (PR + CR + FR) response (RR = 2.8, 95% CI 1.1-7.2), but not ≥90% (CR + FR) response (RR = 8.28, 95% CI 0.65-105.92). Clinic-based neurostimulation had significantly better treatment outcomes for both ≥50% (PR + CR + FR) and ≥90% (CR + FR) responses (RR = 3.24, 95% CI 1.89-5.57; RR = 20.81, 95% CI 2.97-145.59, respectively), whereas a self-administered regimen showed no differences for both ≥50% (PR + CR + FR) and ≥90% (CR + FR) response rates between treatment groups (RR = 2.61, 95% CI 0.48-14.15; RR = 3.55, 95% CI 0.19-67.82, respectively). No serious adverse events were reported.
Conclusion: Neurostimulation therapy may lead to better partial improvement of non-neurogenic overactive bladder; however, it may not render a definitive complete response. Office-based neurostimulation seems more efficacious than self-administered neurostimulation. Further RCTs are needed to compare outcomes of the 2 regimens.
Fuente
Urology; Vol. 110 (2017)
Estadísticas Google Analytics
Colecciones
- Artículos [246]