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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 | Ospina Medina, Maria Cristina | |
dc.creator | Sánchez Cárdenas, Julie Paola | |
dc.creator | Díaz Galindo, Giselle Daniela | |
dc.creator | Villota Barrera, Santiago Andrés | |
dc.creator.degree | Especialista en Epidemiología (en Convenio con el CES) | |
dc.creator.degreeLevel | Especialización | |
dc.creator.degreetype | Full time | |
dc.date.accessioned | 2024-07-15T15:43:06Z | |
dc.date.available | 2024-07-15T15:43:06Z | |
dc.date.created | 2024-07-11 | |
dc.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. | |
dc.description.abstract | 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. | |
dc.format.extent | 81 PP | |
dc.format.mimetype | application/pdf | |
dc.geoLocation | Bogotá | |
dc.identifier.doi | https://doi.org/10.48713/10336_43010 | |
dc.identifier.uri | https://repository.urosario.edu.co/handle/10336/43010 | |
dc.language.iso | spa | |
dc.publisher | Universidad del Rosario | |
dc.publisher | Universidad CES. Facultad de Medicina | |
dc.publisher.department | Escuela de Medicina y Ciencias de la Salud | |
dc.publisher.program | Especialización en Epidemiología | |
dc.rights | Attribution 4.0 International | * |
dc.rights.accesRights | info:eu-repo/semantics/openAccess | |
dc.rights.acceso | Abierto (Texto Completo) | |
dc.rights.licencia | 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. | spa |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
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dc.source.instname | instname:Universidad del Rosario | |
dc.source.reponame | reponame:Repositorio Institucional EdocUR | |
dc.subject | Estimulación nerviosa eléctrica transcutánea | |
dc.subject | Disfunción vejiga intestino | |
dc.subject | Eficacia | |
dc.subject | Niños | |
dc.subject.keyword | Bladder bowel dysfunction | |
dc.subject.keyword | Transcutaneous electrical nerve stimulation | |
dc.subject.keyword | Efficacy | |
dc.subject.keyword | Children | |
dc.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 | |
dc.title.TranslatedTitle | Efficacy of transcutaneous posterior tibial nerve neuromodulation in bladder-bowel dysfunction in children under 18 years of age: a systematic review of the literature. | |
dc.type | bachelorThesis | |
dc.type.document | Trabajo de grado | |
dc.type.hasVersion | info:eu-repo/semantics/acceptedVersion | |
dc.type.spa | Trabajo de grado | |
local.department.report | Escuela de Medicina y Ciencias de la Salud | |
local.regiones | Bogotá |
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