Introduction: Urinary incontinence (UI) after prostatectomy is dif icult to treat and causes profound adver-

Electrostimulation, response of the pelvic floor muscles, and urinary incontinence in elderly patients post prostatectomy [I] Eletroestimulação, resposta dos músculos do assoalho pélvico e incontinência urinária em pós-prostatectomizados [A] Patrícia Zaidan [a] , Elirez Bezerra da Silva [b] [a] Specialist in Urogynecological Physical Therapy, University Gama Filho (UGF -RJ), collaborator physical therapist of the Outpatient Urogynecologic Physical Therapy of Hospital dos Servidores do Estado do Rio de Janeiro, Rio de Janeiro, RJBrazil, e-mail: patriciazaidan@gmail.com [b] PhD in Physical Education, University Gama Filho (UGF -RJ), coordinator of Post-Graduation Course in Physical Therapy (UGF), professor of the Post-Graduation stricto sensu Program in Sciences of the Exercise and Sports (UGF), coordinator of the Research Group Clinical School (UGF), Rio de Janeiro, RJ -Brazil, e-mail: elirezsilva@cosmevelho.com.br [R] Abstract Objective: to investigate the response of the pelvic floor muscles (PFM), and urinary incontinence (UI), in patients having undergone a prostatectomy, after treatment using electrical stimulation. Materials and methods: this observational study was conducted in an outpatient urogynecologic physical therapy clinic of Hospital dos Servidores in Rio de Janeiro, Brazil from August to September 2012. Ten patients (aged, 64 ± 7 years) with urinary incontinence resulting from radical prostatectomy, having received surgery within six months of study entry, without urinary infection, and without metallic implants underwent electrical stimulation of the PFM, while in lateral decubitus position with knees and hips flexed. The parameters used were 65 Hz frequency, pulse width of 500 μs, biphasic current, intensity according to the tolerance level reported by the patient, perineal contraction time of four seconds, and rest time of eight seconds for 20 minutes twice a week, totaling 16 sessions of electrical stimulation with active-assisted contraction. Patients were evaluated before and after electrical stimulation through physical therapy evaluation of urinary incontinence, by being asked about the number of disposable guards used daily, using a visual analogue scale (VAS) to measure how the UI interfered with activities of daily living, and by electromyographic biofeedback to measure the work of the PFM. Data were analyzed using Student's paired t-tests and a significance level of 0.05. Results: after 16 sessions of electrical stimulation, the electromyographic biofeedback evaluation showed a significantFisioter Mov. 2014 jan/mar;27(1):93-100Zaidan P, da Silva EB. 94 increase in muscle strength of 10.73 ± 8.64 to 17.16 ± 9.00 μV (t = -3.39, P = 0.008), a significant decrease in the number of diapers used before and after treatment (3.9 ± 1.2 to 1.8 ± 1.5, respectively; t = 5.16, P = 0.0006), and a significant decrease in the interference of urinary incontinence on daily activities of 9.6 ± 0.5 to 4.0 ± 3.8 (t = 5.15, P = 0.0006). Conclusion: electrical stimulation may represent a nove...

Parkinson é uma doença de sintomas motores e não motores, podendo incluir neste último, a bexiga neurogênica, que se caracteriza por sintomas de urgência, com ou sem urge-incontinência, normalmente acompanhada de polaciúria e noctúria. Objetivo: Analisar a eletroestimulação transcutânea e a percutânea do nervo tibial para tratamento da bexiga hiperativa em Parkinsonianos. Metodologia: Foram incluídos todos os artigos que mencionaram o tratamento da bexiga hiperativa, com eletroestimulação transcutânea e percutânea do tibial posterior, em pacientes com Parkinson. Realizou-se a busca de março a novembro de 2017, nas bases de dados US National Library of Medicine (MEDLINE), Scientific Eletronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro), Biblioteca Virtual em Saúde (BVS) e Google acadêmico, sem limites de data. Foram utilizados como descritores contidos nos Descritores em Ciências da Saúde (DeCS) as palavras-título: bexiga hiperativa, Parkinson e eletroestimulação transcutânea e percutânea do tibial posterior. Foram utilizados como descritores contidos no Medical Subject Headings (MeSH) as palavras-título: overactivity bladder, Parkinson’s disease, electrical stimulation transcutaneous, percutaneous electrical stimulation. Resultados: Dos 8 artigos recuperados, 1 estava duplicado e 2 foram excluídos por não estarem disponíveis, restando cinco artigos: 2 ECRs, 2 experimentais e 1 estudo piloto. Conclusão: a terapia de eletroestimulação tibial, tanto transcutânea, quanto percutânea, se mostra benéfica para tratamento da bexiga hiperativa, em pacientes com Parkinson, porém, se faz necessário a realização de novos estudos, principalmente os de intervenção, para padronização do método.Palavras-chave: eletroestimulação transcutânea do nervo tibial posterior, eletroestimulação percutânea do nervo tibial, bexiga hiperativa e Parkinson.

Introduction: The obtaining of urinary continence is due to the strength of the pelvic floor muscles (MAPs) at the moment of muscle contraction, when there are sudden increases in intra-abdominal pressure, which increases urethral closure pressure and decreases the possibility of urinary loss. Objective: To verify the reliability, type: stability, intra-examiner, of the measure of the strength of MAPs held with Peritron. Methods: Test and retest study to assess the intra-rater reliability of Peritron to measure the strength of MAPs. The sample consisted of 36 male patients, mean age 65.3 ± 7.2 years, all with urinary incontinence (UI) after radical prostatectomy. The physical therapist conducted a training for familiarization with the procedures of MAPs strength assessment with Peritron for two weeks. The strength of MAPs was measured by a perineometer of the Peritron brand (PFX 9300®, Cardio-Design Pty. Ltd, Baulkham Hills, Australia, 2153). Results: The intraclass correlation coefficient (ICC) was equal to 0.99; P = 0.0001. The typical measurement error (ETM) was equal to 3.1 cmH2O and ETM% of 4. Conclusion: Peritron showed high reliability for measuring the strength of MAPs in men, both for clinical practice and for the production of scientific knowledge. It should be noted that such measures were carried out in stability, so it is suggested that in internal consistency reliability is equivalent.