{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:27:10Z","timestamp":1778459230286,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Nocturnal enuresis (NE) is a common pathology in children that can have significant behavioral, emotional, and social impacts on a child's life. Recent studies have assessed PTENS as a potential treatment method for NE, particularly in those who do not respond to initial first\u2010line treatments. Literature has shown varying results with regard to its success. There has been no systematic review and meta\u2010analysis to date assessing outcomes following this treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Despite multiple studies showing the potential benefits of PTENS in NE, there has been no consensus regarding its efficacy. The aim of this study was to systematically analyze the effects of PTENS on children with NE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>In September 2021, a search of PubMed, Embase and the Cochrane Library was carried out for studies relating to outcomes following PTENS in children with NE. Studies included were original publication English language randomized controlled trial (RCT's) with at least ten children receiving parasacral transcutaneous electrical nerve stimulation (PTENS). After assessing for relevant studies, data were collated and analyzed from the included studies. Risk of bias was assessed using the Cochrane seven domain assessment. Our primary outcome was response and nonresponse to treatment. These results were combined in a fixed effects meta\u2010analysis model to obtain an overall estimate of the success rate. Information regarding demographics was also collected. There was no external funding for this review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 145 studies found initially, four RCT's\u00a0(208 children) were included. The weighted mean rate of full response to active PTENS was 10.8% (0%\u221219%). All studies considered, meta\u2010analysis showed no difference between PTENS and controls (RR: 0.70, 95% confidence interval [CI: 0.37\u22121.32]). Subgroup analysis of monosymptomatic enuresis showed no effect of PTENS compared to controls (RR\u2009=\u20090.58, 95% CI: [0.24\u22121.42]). When grouped, studies comparing PTENS to sham\/behavioral treatment showed no benefit compared to controls (RR\u2009=\u20090.81, 95% CI:\u00a0[0.05\u221212.53]) and those comparing PTENS to biofeedback\/interferential current (IFC) showed no difference to controls (RR\u2009=\u20090.69, 95% CI: [0.36\u22121.33]). There was no evidence of a difference between cases and controls between these latter subgroups (RR\u2009=\u20090.70, 95% CI: [0.37\u22121.32]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion\/Conclusion<\/jats:title><jats:p>Our results suggest that PTENS has no clear benefit in the management of children with NE compared to controls. Subgroup analysis showed that its use in monosymptomatic NE has no clear advantage. However, this review has highlighted the need for further high quality studies. Limitations to this review included a relatively small sample size and the use of prior or concomitant therapies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25039","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T08:45:09Z","timestamp":1662540309000},"page":"1659-1669","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Assessing the outcomes of parasacral transcutaneous electrical nerve stimulation (PTENS) in the treatment of enuresis in children: A systematic review and meta\u2010analysis of randomized control trials"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2026-7584","authenticated-orcid":false,"given":"James","family":"Toale","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery and Urology Children's Health Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Kelly","sequence":"additional","affiliation":[{"name":"School of Mathematics and Statistics University College Dublin Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Hajduk","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology Children's Health Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology Children's Health Dublin Ireland"},{"name":"School of Medicine University College Dublin Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23917"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2019.12.020"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.02.040"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365590701748054"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.1998.00018.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655901750291908"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000052236"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922893032001S02"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2006.tb01360.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.07.061"},{"key":"e_1_2_8_12_1","first-page":"38","article-title":"Primary nocturnal enuresis: a review","volume":"14","author":"Hodge\u2010Gray E","year":"1998","journal-title":"J Sch Nurs"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsj037"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2002.tb01673.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.49.4.259"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2006.06074.x"},{"key":"e_1_2_8_17_1","first-page":"CD002911","article-title":"Alarm interventions for nocturnal enuresis in children","volume":"5","author":"Caldwell PH","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_18_1","first-page":"CD002112","article-title":"Desmopressin for nocturnal enuresis in children","volume":"3","author":"Glazener CM","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.10.088"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24601"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.04.082"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.03.108"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-019-02340-w"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22751"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.2307\/2685469"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"e_1_2_8_28_1","unstructured":"TLMax Gordon.\u00a02020. 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