Comparison between two different neuromuscular electrical stimulation protocols for the treatment of female stress urinary incontinence: a randomized controlled trial

Alves, Priscila G. J. M.; Nunes, Fabiana Roberta; Guirro, Elaine Caldeira de Oliveira

doi:10.1590/s1413-35552011005000010

Cited by 33 publications

(25 citation statements)

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“…Its adverse events reported during the studies (vaginal irritation, occasional pain, vaginal infection, urinary tract infection) were not severe, and were reversible (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

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Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

et al. 2013

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Background: Electrical stimulation is commonly recommended to treat urinary incontinence in women. It includes several techniques that can be used to improve stress, urge, and mixed symptoms. However, the magnitude of the alleged benefits is not completely established. Objectives: To determine the effects of electrical stimulation in women with symptoms or urodynamic diagnoses of stress, urge, and mixed incontinence. Search Strategy: Our review included articles published between January 1980 and January 2012. We used the search terms "urinary incontinence", "electrical stimulation", "intravaginal", "tibial nerve" and "neuromodulation" for studies including female patients. Selection Criteria: We evaluated randomized trials that included electrical stimulation in at least one arm of the trial, to treat women with urinary incontinence. Data Collection and Analysis: Two reviewers independently assessed the data from the trials, for inclusion or exclusion, and methodological analysis. Main Results: A total of 30 randomized clinical trials were included. Most of the trials involved intravaginal electrical stimulation. Intravaginal electrical stimulation showed effectiveness in treating urge urinary incontinence, but reported contradictory data regarding stress and mixed incontinence. Tibial-nerve stimulation showed promising results in randomized trials with a short follow-up period. Sacral-nerve stimulation yielded interesting results in refractory patients. Conclusions: Tibial-nerve and intravaginal stimulation have shown effectiveness in treating urge urinary incontinence. Sacral-nerve stimulation provided benefits in refractory cases. Presently available data provide no support for the use of intravaginal electrical stimulation to treat stress urinary incontinence in women. Further randomized trials are necessary to determine the magnitude of benefits, with long-term follow-up, and the effectiveness of other electrical-stimulation therapies.

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“…Its adverse events reported during the studies (vaginal irritation, occasional pain, vaginal infection, urinary tract infection) were not severe, and were reversible (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

“…Ten trials to treat stress urinary incontinence were included with a total of 765 patients (18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Most patients in all trials were close to 50 years of age.…”

Section: Stress Urinary Incontinencementioning

confidence: 99%

Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

et al. 2013

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“…The few randomized clinical trials to date advocate using 20–50 Hz for SUI. The equipment is used transvaginally in daily sessions for 15–30 min at the maximum intensity individually tolerated for a variable period of 4–12 weeks [13, 14]. The results of randomized controlled trials evaluating the effect of (ES) to treat SUI are conflicting.…”

Section: Introductionmentioning

confidence: 99%

Transvaginal electrical stimulation with surface-EMG biofeedback in managing stress urinary incontinence in women of premenopausal age: a double-blind, placebo-controlled, randomized clinical trial

et al. 2013

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Introduction and hypothesisThe aim of this study was to evaluate the results of conservative treatment of urodynamic stress urinary incontinence (SUI) using transvaginal electrical stimulation with surface-electromyography-assisted biofeedback (TVES + sEMG) in women of premenopausal age.MethodsOne hundred and two patients with SUI were divided into two groups: active (n = 68) and placebo (n = 34) TVES + sEMG. The treatment lasted for 8 weeks and consisted of two sessions per day. Women were evaluated before and after the intervention by pad test, voiding diary, urodynamic test, and the Incontinence Quality of Life Questionnaire (I-QOL).ResultsMean urinary leakage on a standard pad test at the end of 8th week was significantly lower in the active than the placebo group (19.5 ± 13.6 vs. 39.8 ± 28.5). Mean urinary leakage on a 24-h pad test was significantly reduced in the active group at the end of 8th and 16th weeks compared with the placebo group (8.2 ± 14.8 vs. 14.6 ± 18.9 and 6.1 ± 11.4 vs. 18.2 ± 20.8, respectively). There was also a significant improvement in muscle strength as measured by the Oxford scale in the active vs the placebo group after 8 and 16 weeks (4.2 vs 2.6 and 4.1 vs 2.7, respectively). No significant difference was found between groups in urodynamic data before and after treatment. At the end of 8th week, the mean I-QOL score in the active vs the placebo group was 78.2 ± 17.9 vs 55.9 ± 14.2, respectively, and at the end of 16th week 80.8 ± 24.1 vs. 50.6 ± 14.9, respectively.ConclusionOur study showed that TVES + sEMG is a trustworthy method of treatment in premenopausal women with SUI; however, its reliability needs to be established.

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“…The activity of pelvic and perineal muscles during the micturition of women and female rabbits show some similarities. For example, the Pcm activity shown during the storage phase is a major component in the mechanism of urinary continence, because the electrical stimulation inhibits the bladder contraction and the urine output (Alves et al, 2011;our unpublished results). This is possible because the contraction of the Pcm during voiding is produced by the discharge of some of its afferents (from muscle spindles or tendon organs), sending information to both sacral 2 and 4 to modulate the activity of parasympathetic neurons (Manzo et al, 1997;Thor & de Groat, 2010).…”

Section: Pelvic-and Perineal-muscle Activities During Micturitionmentioning

confidence: 96%