Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura

La disfunción vejiga intestino (DVI) es una entidad frecuente en la población pediátrica e implica manejo conductual y farmacológico prolongado. La neuromodulación eléctrica transcutánea del nervio tibial posterior (NETTP) surge como un manejo adyuvante de tercera línea en estos pacientes, no invasi...

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2024
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Universidad del Rosario
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Repositorio EdocUR - U. Rosario
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spa
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oai:repository.urosario.edu.co:10336/43010
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https://repository.urosario.edu.co/handle/10336/43010
Palabra clave:
Estimulación nerviosa eléctrica transcutánea
Disfunción vejiga intestino
Eficacia
Niños
Bladder bowel dysfunction
Transcutaneous electrical nerve stimulation
Efficacy
Children
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id EDOCUR2_d60c21b5b147db3e4caaf20a50c1d842
oai_identifier_str oai:repository.urosario.edu.co:10336/43010
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.none.fl_str_mv Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
dc.title.TranslatedTitle.none.fl_str_mv Efficacy of transcutaneous posterior tibial nerve neuromodulation in bladder-bowel dysfunction in children under 18 years of age: a systematic review of the literature.
title Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
spellingShingle Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
Estimulación nerviosa eléctrica transcutánea
Disfunción vejiga intestino
Eficacia
Niños
Bladder bowel dysfunction
Transcutaneous electrical nerve stimulation
Efficacy
Children
title_short Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
title_full Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
title_fullStr Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
title_full_unstemmed Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
title_sort Eficacia de la neuromodulación transcutánea del nervio tibial posterior en la disfunción vejiga intestino en menores de 18 años: revisión sistemática de la literatura
dc.contributor.advisor.none.fl_str_mv Ospina Medina, Maria Cristina
dc.subject.none.fl_str_mv Estimulación nerviosa eléctrica transcutánea
Disfunción vejiga intestino
Eficacia
Niños
topic Estimulación nerviosa eléctrica transcutánea
Disfunción vejiga intestino
Eficacia
Niños
Bladder bowel dysfunction
Transcutaneous electrical nerve stimulation
Efficacy
Children
dc.subject.keyword.none.fl_str_mv Bladder bowel dysfunction
Transcutaneous electrical nerve stimulation
Efficacy
Children
description La disfunción vejiga intestino (DVI) es una entidad frecuente en la población pediátrica e implica manejo conductual y farmacológico prolongado. La neuromodulación eléctrica transcutánea del nervio tibial posterior (NETTP) surge como un manejo adyuvante de tercera línea en estos pacientes, no invasiva, segura y menos costosa. OBJETIVO: Sintetizar la evidencia existente sobre efectividad de la NTTP en el manejo de la DVI en menores de 18 años. METODOLOGÍA: Revisión sistemática de la literatura de artículos obtenidos a partir de las bases de datos elegidas entre enero 2010 y febrero 2024, donde se preseleccionaron un total de 133 artículos a los cuales se les aplicó el proceso de depuración de la información y según criterios de inclusión se obtuvo una selección final de ocho publicaciones, se extrajo la información referente a datos demográficos, la intervención y los desenlaces y se realizó un análisis con evaluación de calidad metodológica con CONSORT y STROBE, y la evaluación de riesgo de sesgos con ROBINS-E y ROB2. RESULTADOS: Se obtuvieron 8 estudios, 5 ensayos clínicos aleatorios (ECA) y 3 tipos cohorte, un tamaño muestral total de 431 pacientes. En función del subtipo, 2 estudios abordaron el estreñimiento, 2 incontinencias fecales, 4 evaluaron enuresis, un estudio urgencia miccional. La mayoría de los estudios incluso pacientes escolares entre 4 a 16 años, con NTTP aplicada en sesiones diarias de 30 minutos, variando entre los estudios el tiempo de intervención y la intensidad de la estimulación eléctrica. En la mayoría de los estudios hubo mejoría en al menos 1 síntoma y de manera global se describió tasa de efectividad alrededor del 75% para incontinencia fecal y estreñimiento. La mayoría de los estudios evaluó el impacto en calidad de vida, con mejoría en la puntuación posterior a la intervención. Solo un paciente presento calambres como único evento adverso. CONCLUSIÓN: La NTTP muestra ser eficaz como tratamiento adyuvante en el síndrome DVI en pediatría, aunque se requieren más ensayos clínicos para establecer recomendaciones y tasas de eficacia. Se resalta la necesidad de más ECA, con estandarización en la técnica y evaluación a largo plazo, con mayor rigurosa metodología, para definir protocolos de manejo.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-07-15T15:43:06Z
dc.date.available.none.fl_str_mv 2024-07-15T15:43:06Z
dc.date.created.none.fl_str_mv 2024-07-11
dc.type.none.fl_str_mv bachelorThesis
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.document.none.fl_str_mv Trabajo de grado
dc.type.spa.none.fl_str_mv Trabajo de grado
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/43010
url https://repository.urosario.edu.co/handle/10336/43010
dc.language.iso.none.fl_str_mv spa
language spa
dc.rights.*.fl_str_mv Attribution 4.0 International
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.none.fl_str_mv Abierto (Texto Completo)
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by/4.0/
rights_invalid_str_mv Attribution 4.0 International
Abierto (Texto Completo)
http://creativecommons.org/licenses/by/4.0/
http://purl.org/coar/access_right/c_abf2
dc.format.extent.none.fl_str_mv 81 PP
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad del Rosario
Universidad CES. Facultad de Medicina
dc.publisher.department.none.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv Especialización en Epidemiología
publisher.none.fl_str_mv Universidad del Rosario
Universidad CES. Facultad de Medicina
institution Universidad del Rosario
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spelling Ospina Medina, Maria Cristina57211317-3d37-4da8-a2b3-24a6ec34cb27-1Sánchez Cárdenas, Julie PaolaDíaz Galindo, Giselle DanielaVillota Barrera, Santiago AndrésEspecialista en Epidemiología (en Convenio con el CES)EspecializaciónFull timef11bbdcf-5aa6-4545-b3e5-0bc53b8a715d-1329e2141-8036-4964-85ab-6ef2a71e69482b62d3e6-19fa-432f-a2b2-a50edf02681a2024-07-15T15:43:06Z2024-07-15T15:43:06Z2024-07-11La disfunción vejiga intestino (DVI) es una entidad frecuente en la población pediátrica e implica manejo conductual y farmacológico prolongado. La neuromodulación eléctrica transcutánea del nervio tibial posterior (NETTP) surge como un manejo adyuvante de tercera línea en estos pacientes, no invasiva, segura y menos costosa. OBJETIVO: Sintetizar la evidencia existente sobre efectividad de la NTTP en el manejo de la DVI en menores de 18 años. METODOLOGÍA: Revisión sistemática de la literatura de artículos obtenidos a partir de las bases de datos elegidas entre enero 2010 y febrero 2024, donde se preseleccionaron un total de 133 artículos a los cuales se les aplicó el proceso de depuración de la información y según criterios de inclusión se obtuvo una selección final de ocho publicaciones, se extrajo la información referente a datos demográficos, la intervención y los desenlaces y se realizó un análisis con evaluación de calidad metodológica con CONSORT y STROBE, y la evaluación de riesgo de sesgos con ROBINS-E y ROB2. RESULTADOS: Se obtuvieron 8 estudios, 5 ensayos clínicos aleatorios (ECA) y 3 tipos cohorte, un tamaño muestral total de 431 pacientes. En función del subtipo, 2 estudios abordaron el estreñimiento, 2 incontinencias fecales, 4 evaluaron enuresis, un estudio urgencia miccional. La mayoría de los estudios incluso pacientes escolares entre 4 a 16 años, con NTTP aplicada en sesiones diarias de 30 minutos, variando entre los estudios el tiempo de intervención y la intensidad de la estimulación eléctrica. En la mayoría de los estudios hubo mejoría en al menos 1 síntoma y de manera global se describió tasa de efectividad alrededor del 75% para incontinencia fecal y estreñimiento. La mayoría de los estudios evaluó el impacto en calidad de vida, con mejoría en la puntuación posterior a la intervención. Solo un paciente presento calambres como único evento adverso. CONCLUSIÓN: La NTTP muestra ser eficaz como tratamiento adyuvante en el síndrome DVI en pediatría, aunque se requieren más ensayos clínicos para establecer recomendaciones y tasas de eficacia. Se resalta la necesidad de más ECA, con estandarización en la técnica y evaluación a largo plazo, con mayor rigurosa metodología, para definir protocolos de manejo.Bowel bladder dysfunction (BBD) is a common entity in children and requires prolonged behavioral and pharmacological management. Transcutaneous Electrical Nerve Stimulation of the posterior tibial (TENS-PT) nerve emerges as third-line adjuvant management in these patients, non-invasive, safe, and less expensive. OBJECTIVE: To synthesize the existing evidence on the effectiveness of TENS-PT in the management of BBD in children. METHODOLOGY: A systematic literature review was conducted on articles retrieved from selected databases between January 2010 and February 2024. A total of 133 articles were preselected and subjected to data refinement. Based on inclusion criteria, a final selection of eight publications was obtained. Relevant information regarding demographic data, interventions, and outcomes was extracted, and a methodological quality assessment was performed using CONSORT and STROBE guidelines, along with bias risk assessment using ROBINS-E and ROB2. RESULTS: A total of 8 studies were identified (5 randomized clinical trials and 3 cohorts), involving 431 patients. Two studies addressed constipation, two addressed fecal incontinence, four evaluated enuresis, and one addressed urinary urgency. Most studies included school-aged patients between 4 and 16 years old, with TNMTP applied in daily sessions of 30 minutes. Most included school-aged patients aged 4 to 16, with daily sessions lasting 30 minutes. Although the duration and intensity of electrical stimulation varied, improvement in at least one symptom was observed in most studies, with an overall effectiveness rate of 75% for fecal incontinence and constipation. The impact on quality of life was assessed in most studies, with improvement in post-intervention scores. Only one patient experienced cramps as the sole adverse event. CONCLUSION: TENS-PT has shown effective as an adjuvant treatment for BBD syndrome in pediatrics, although more clinical trials are required to establish recommendations and efficacy rates. The need for more randomized clinical trials is highlighted, with standardization in the technique, long-term evaluation, and a more rigorous methodology to define management protocols.81 PPapplication/pdfBogotáhttps://repository.urosario.edu.co/handle/10336/43010spaUniversidad del RosarioUniversidad CES. Facultad de MedicinaEscuela de Medicina y Ciencias de la SaludEspecialización en EpidemiologíaAttribution 4.0 InternationalAbierto (Texto Completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://creativecommons.org/licenses/by/4.0/http://purl.org/coar/access_right/c_abf21. 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