Researchers have found that magnetic stimulation of the lower back can reduce the frequency of nighttime bed-wetting and improve quality-of-life for sufferers.
Bedwetting, or nocturnal enuresis, causes distress in children and young adults, as well as for their parents or caregivers.
Researchers have now found that repetitive sacral root magnetic stimulation (rSMS) can reduce the frequency of nighttime bedwetting.
In a study conducted by researchers at the Assiut University Hospital, Egypt, 41 patients experiencing nocturnal enuresis were divided into two groups receiving either real magnetic stimulation or a sham stimulation using the same equipment and procedures.
Each participant received 10 sessions, five per week.
A magnetic stimulator was placed over the sacral vertebrae in the lower back and 15 Hz pulses were applied for 10 seconds on and 30 seconds off.
For the sham procedure, the stimulator was internally adjusted so that little magnetic stimulation could reach the underlying tissue.
All patients had been taking the tricyclic antidepressant drug imipramine for at least three months without satisfactory results and they continued taking their prescribed medication throughout the study.
"It seems likely that rSMS produced some of its effect in the present patients by a direct effect on bladder control," said lead investigator Eman M Khedr, professor at the Department of Neurology, Assiut University Hospital.
"In the present study rSMS could have increased arousal or enhanced inhibition of neuronal re-uptake of noradrenaline and serotonin," Khedr said.
"We have previously reported that patients with nocturnal enuresis have pathologically increased excitability and reduced inhibitory processing in the motor cortex and it is possible that rSMS could affect these measures as well," Khedr said.
The average number of weekly nocturnal bedwetting episodes fell from 5.7 to 0.3 per week after the end of the treatment sessions for the real group compared to 6.5 to 1.8 per week after sham stimulation.
Although the sham procedure resulted in improvement (placebo effect), the improvement in the real group continued one month later (1 per week) whereas the sham group returned to baseline behaviour (5.2 per week).
All patients were asked to complete a Visual Analogue Scale (VAS) and a generic Health Survey (SF-36v2). The VAS assesses how bedwetting affects the patient's life, while the Health Survey measures physical health and mental well-being in eight different health domains.
The treatment resulted in significant improvements in the mental health scores including social functioning, vitality, mental health, and component mental health summation in the real group compared to the sham group.
The study was published in the journal Restorative Neurology and Neuroscience.
