One month maximal electrostimulation for genuine stress incontinence in women

Schiøotz, Hjalmar A.

doi:10.1002/nau.1930130107

Cited by 13 publications

(4 citation statements)

References 19 publications

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“…Currently, SUI is treated mainly surgically (with >100 different surgical procedures reported), while medical treatment has been widely used for patients with urge and mixed UI (MUI). The use of continuous electrical stimulation (ES) for urinary SUI has high claimed success rates [4,5]. Electrical neuromodulation to the sacral roots, or peripherally to nerve pathways, has been used for >20 years in well defined conditions in patients with mainly urge but also with SUI.…”

Section: Introductionmentioning

confidence: 99%

Patient‐adjusted intermittent electrostimulation for treating stress and urge urinary incontinence

et al. 2004

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OBJECTIVE To assess the safety and efficacy of pelvic floor muscle electrostimulation (ES) in women with stress urinary incontinence (SUI) or mixed UI (MUI, urge and interstitial cystitis), using a new portable electrostimulator (Miniaturo, Biocontrol Medical Inc., Yehud, Israel) which delivers different forms of stimulation for treating these two conditions. PATIENTS AND METHODS For SUI the stimulator is activated on demand only by a sudden increase in intra‐abdominal pressure; for frequency and urgency a milder, continuous ES is used. The intensity of ES can be adjusted according to the patient's sensation. Women were enrolled into the study after satisfying inclusion criteria and pad testing; 23 participated in two study groups, i.e. 16 with SUI and seven with MUI (severe frequency, urgency and urge, and mild SUI). The pelvic floor muscles were stimulated through an electrode inserted paraurethrally, positioned similarly in all patients. In patients with SUI and MUI a pressure sensor was also inserted into the rectum, to record intra‐abdominal pressure. Stimulation was applied for 1–4 h in patients with SUI and for 6 h in those with MUI. The evaluation was based on urinary symptoms (frequency, urgency, leaking episodes), quality‐of‐life questionnaires and pad tests at baseline and during stimulation. RESULTS All patients in both groups improved significantly; of the 16 patients with SUI, nine were completely dry during ES, and the remaining seven had a reduced mean pad weight, from 23 to 6 g (74%). There was no significant reduction in pad weight after sham ES (17 g before vs 24.2 g after). In four patients with SUI who continued ES for 4 h the mean cumulative stimulation time (calculated from the stimulator memory) was 3 min (1.3% of 4 h). In the MUI group there were no leakage episodes during ES and significant reductions in voiding variables (Student's t‐test) in all. The mean (Sd) voiding frequency, urinary urgency and leaking episodes decreased from 8.1 (4.2) to 1.9 (1.5), 6.4 (2.3) to 0.7 (1.3) and 2.1 (0.7) to 0.7 (0.5) (all P < 0.001), respectively. CONCLUSIONS The concept of this ES system for treating UI is promising; this study supports the efficacy of this form of ES but no conclusions about clinical efficacy are possible at this stage, and thus a trial to evaluate the safety and efficacy of this implantable device is ongoing.

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Section: Introductionmentioning

confidence: 99%

Patient‐adjusted intermittent electrostimulation for treating stress and urge urinary incontinence

et al. 2004

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“…cal stimulation is that the current will cause a pelvic floor muscle (PFM) contraction similar to a voluntary contraction, thus strengthening the PFM [1,4,5].…”

mentioning

confidence: 99%

Change in urethral pressure during voluntary pelvic floor muscle contraction and vaginal electrical stimulation

Bø¹,

Talseth²

1997

Int Urogynecol J

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The purpose of the study was to compare the effect of voluntary pelvic floor muscle (FFM) contraction and vaginal electrical stimulation on urethral pressure. Twelve women with genuine stress incontinence, mean age 49.4 years (range 33-66) participated in the study. The urethral and bladder pressures were recorded simultaneously through a double-lumen 8 Ch catheter. The patients first performed three voluntary PFM contractions. Then two electrical stimulators, Conmax and Medicon MS 105, 50 Hz, were used in random order. A visual analog scale was used to measure pain and discomfort. Pain was reported to mean 6.8, SEM 0.64 (range 0.7-9.9) and mean 6.1, SEM 0.81 (range 0-9.1) with Conmax and Medicon MS 105, respectively. The mean paired difference in favor of voluntary contraction with Conmax was -8.0, SD 6.7, P = 0.0067, and with Medicon MS 105 it was -12.2, SD 5.9, P = 0.0022. The results demonstrated that voluntary PFM contraction increased urethral pressure significantly more than did vaginal electrical stimulation.

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“…Subsequent experiments with transcutaneous electrical stimulation of the pudendal nerve via electrodes on the anal mucosa, vaginal mucosa, perineal skin and penis have all been shown to have beneficial effects on incontinence [1][2][3][4][5][6]. Early studies reporting the use of continuous electrical stimulation claimed high success rates, but the claims were often based on uncontrolled tests of efficacy.…”

Section: Therapeutic Neuromodulationmentioning

confidence: 99%

“…These techniques may now provide a very different option for treatment. Stimulation sites have included anal, intravaginal, intravesical, and transcutaneous at several locations on the body surface [1][2][3][4][5][6]. Because of varying success rates, most of these methods have never gained widespread application but direct sacral nerve stimulation has been made clinically applicable through the work of Schmidt and Tanagho [7,8] and others [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Neuromodulation by Implant for Treating Lower Urinary Tract Symptoms and Dysfunction

1999

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One month maximal electrostimulation for genuine stress incontinence in women

Cited by 13 publications

References 19 publications

Patient‐adjusted intermittent electrostimulation for treating stress and urge urinary incontinence

Patient‐adjusted intermittent electrostimulation for treating stress and urge urinary incontinence

Change in urethral pressure during voluntary pelvic floor muscle contraction and vaginal electrical stimulation

Neuromodulation by Implant for Treating Lower Urinary Tract Symptoms and Dysfunction

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