Australian and New Zealand Continence Journal

Background Chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS) is a debilitating condition and diagnosing and managing this condition is challenging.

Objectives A systematic review was conducted to: (i) investigate the effects of conservative management on people with Type III A/B CP/CPPS; (ii) review study enrolment criteria used to enrol participants with Type III A/B CP/CPPS; (iii) investigate the description of the diagnostic outcomes and corresponding interventions used across studies.

Methods Electronic databases were searched to September 2024. Outcomes assessed included pain, urinary symptoms and quality of life. Included studies were assessed using the Template for Intervention Description and Replication checklist, Joanna Briggs Institute critical appraisal checklist, and the Grading of Recommendation, Assessment, Development, and Evaluations guideline.

Results and Discussion Twenty studies were included. GRADE evidence quality was very-low for all studies. Electrical stimulation and non-electrotherapy intervention showed improvements in pain, urinary symptoms and quality of life. Electromagnetic therapy did not improve reported outcomes. Studies reporting adverse events were mild and transient. Enrolment criteria used to diagnose Type III A/B CP/CPPS were varied. Most interventions targeted the pelvic floor only despite patients’ reported pain locations and the outcomes of the diagnostic outcomes reported in each study.

Conclusion Preliminary findings suggests that electrical stimulation is a promising intervention for pain, urinary symptoms and QoL. Adjunct therapies including pelvic floor biofeedback and targeted manual therapy can be considered, if supported by examination findings. Interventions should be tailored based on patients’ clinical presentations and specific exam findings.

Main problem There is uncertainty about the effect of transcutaneous electrical nerve stimulation on quality of life and psychosocial outcomes in children with lower urinary tract symptoms. We aim to describe its impact on quality of life, psychosocial outcomes and lower urinary tract symptoms in Australian children with overactive bladder while exploring the role of confounders including baseline co-morbidities and length of transcutaneous electrical nerve stimulation usage at home.

Methods Children aged four to 18 years with symptoms of overactive bladder were given a transcutaneous electrical nerve stimulation machine for use at home. Data was collected at baseline and again three months later using a modified Paediatric Incontinence Quality of life Questionnaire, Strengths and Difficulties Questionnaire and an Incontinence Questionnaire and compared using paired t-tests. Separate analysis by gender, lower urinary tract symptoms and comorbidities was conducted.

Results Thirty-one children (15 girls) aged six to 16 years enrolled. The mean change in total Quality of Life Questionnaire score from baseline to post-treatment was -0.2 (95%CI-0.5 to 0.1; p=0.1), change in total Strengths and Difficulty Questionnaire score was -0.1 (95%CI-1.5 to 1.2; p=0.8) and change in total Incontinence Questionnaire score was -1.9 (95%CI-2.9 to -1.0; p=0.0004).

Five participants who were positive for lower urinary tract symptoms at baseline became negative post treatment, whereas no participants without symptoms at baseline became positive post-treatment (p=0.025).

Conclusions Transcutaneous electrical nerve stimulation monotherapy administered at home is potentially an effective treatment option for children with overactive bladder without adversely affecting their quality of life and psychosocial wellbeing.

A recent publication in the New Zealand Medical Journal identified that 43.5% of New Zealand women between the ages of 16 and 74 report at least some urinary incontinence.