Effect of intravaginal electrical stimulation on pelvic floor muscle strength

Abstract

The aim of this study was to evaluate the effect of intravaginal electrical stimulation (IES) on pelvic floor muscle (PFM) strength in patients with mixed urinary incontinence (MUI). Between January 2001 and February 2002, 40 MUI women (mean age: 48 years) were studied. Urge incontinence was the predominant symptom; 92.5% also presented mild stress urinary incontinence (SUI). Selection criteria were clinical history and urodynamics. Pre-treatment urodynamic study showed no statistical differences between the groups. Ten percent of the women in each group had involuntary detrusor contractions. Patients were randomly distributed, in a double-blind study, into two groups. Group G1 (n=20), effective IES, and group G2 (n=20), sham IES, with follow-up at 1 month. The following parameters were studied: (1) clinical questionnaire, (2) examiner's evaluation of perineal muscle strength, (3) objective evaluation of perineal muscle by perineometry, (4) vaginal weight test, and (5) urodynamic study. The IES protocol consisted of three 20-min sessions per week over a 7-week period using a Dualpex Uro 996 at 4 Hz. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence, present in all patients before treatment, was reduced to 15% in G1 and 31.5% in G2 post-treatment. The subjective evaluation of PFM strength demonstrated a significant improvement in G1. Objective evaluation of PFM force by perineometer showed a significant improvement in maximum peak contraction post-treatment in both groups. In the vaginal weight test, there was a significant increase in average number of cone retentions post-treatment in both groups. With regard to satisfaction level, after treatment, 80% of the patients in G1 and 65% of the patients in G2 were satisfied. There was no statistically significant difference between the groups. There was a significant improvement in PFM strength from both effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy in treating MUI.

Tratamiento de la incontinencia urinaria de esfuerzo con Biofeedback perineal con electrodos de superficie

“…Hemos encontrado, al igual que otros autores 29 , que los resultados utilizando electrodos sin electroestimulación son mejores que los obtenidos con electroestimulación. Esto se ha demostrado tanto con electroestimulación superficial como con electroestimulación intravaginal 34 , de forma que tanto el número de micciones en 24 horas como la satisfacción obtenida con el tratamiento fue significativamente superior en las mujeres tratadas sin electroestimulación. La IU de urgencia se reduce incluso más en las pacientes sometidas a un protocolo riguroso sin electroestimulación (31% de reducción de episodios de IU de urgencia frente a 15% de reducción de episodios en mujeres con electroestimulación.…”

“…Aunque en la evaluación subjetiva parece que hay diferencias en la mejoría en la IU de urgencia a favor de pacientes tratadas con electroestimulación, la evaluación objetiva utilizando perineómetro no ha arrojado diferencias estadística-mente significativas entre grupos tratados con y sin electroestimulación, encontrando en todas las pacientes una mejoría importante con el tratamiento. Igualmente ocurre con el test de peso vaginal: no hay diferencias en la mejoría encontrada en las pacientes tratadas con y sin electroestimulación 34 .…”

Évaluation prospective d’un dispositif de rééducation périnéale à domicile dans l’incontinence urinaire d’effort féminine

“….). Pour d'autres, la prise de conscience des muscles du plancher pelvien et de leur coordination constitue un facteur confondant important expliquant l'efficacité relative du placebo [38,42].…”

Treatment of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

“…This kind of treatment is suspected to enhance the inhibitory effect of pelvic floor contraction on the detrusor muscle. 5 Several authors have demonstrated the positive influence of PFMT on disease course. [6][7][8][9] However, it is difficult to make general treatment recommendations based on these reports, as they only discuss low-volume, gender-specific methods of outcome assessment.…”