Effectiveness of Transcutaneous Tibial Nerve Stimulation in Pediatric Patients With Neurogenic Bladder Secondary to Spina Bifida
The purpose of this research study is to determine the effectiveness of a treatment called transcutaneous tibial nerve stimulation or TTNS in the treatment of urinary leakage for patients with spina bifida. This treatment involves electrical stimulation of a nerve by the ankle. Participants will complete urodynamic testing and questionnaires prior to the treatments. Participants will then complete 6 weekly treatments of TTNS. Participants will learn how to do the treatment in the clinic, and then can complete the treatments at home. For patients with a good response, the treatments may be continued for another 6 weeks, for a total of 6 weeks.
• Age 8-18
• Patient at TSRH
• Diagnosis of lumbosacral spina bifida (myelomeningocele, meningocele, lipoma of spinal cord, myelocystocele, diastematomyelia, fatty/thickened filum)
• Incontinence refractory to compliant catheterization (compliance with catheterization as assessed by their treating provider)
• Patient able and willing to undergo urodynamic testing without sedation
• No surgical reconstruction with the exception of a single appendicovesicostomy (APV)
• No Botox treatments within 1 year of enrollment
• Patient willing and able to stop bladder medications (anticholinergics or beta agonists) 2 weeks prior to pre-intervention bladder diary, questionnaires and UDS
• Patient lives close enough to TSRH and CMC to be willing to return for UDS, teaching, and clinic visits as detailed above
• Patient/family speak English