Efficacy of intravaginal electrical stimulation added to bladder training in women with idiopathic overactive bladder: A prospective randomized controlled trial

Abstract

Purpose: To evaluate the efficacy of intravaginal electrical stimulation (IVES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Materials and Methods: Sixty-two women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n:31), and Group 2 received BT+IVES (n:31). IVES was performed for twenty minutes three days a week over a course of eight weeks for a total of 24 sessions. Patients were evaluated in terms of incontinence severity (24-hour pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes and number of pads), symptom severity (OAB-V8), incontinence-related QoL (IIQ-7), treatment success (positive response rate), cure/improvement rate and treatment satisfaction (Likert scale). Results: A statistically significant improvement was found in all parameters for all groups at the end of the treatment compared to the baseline values except pelvic floor muscles strength in Group 1 (p <0.05). At the end of treatment, incontinence severity, frequency of voiding, nocturia, incontinence episodes, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p <0.05). Treatment satisfaction, cure/improvement, and positive response rates were significantly higher in group 2 compared to Group 1 (p <0.05). Conclusion: We conclude that BT+IVES were more effective than BT alone on both incontinence-related QoL and clinical parameters in women with idiopathic OAB.

Biofeedback‐assisted pelvic floor muscle training and pelvic electrical stimulation in women with overactive bladder: A systematic review and meta‐analysis of randomized controlled trials

“…In contrast, a pooled analysis of four studies 13,21,23,25 including 203 individuals found that the ES group outperformed the control group in terms of the number of people cured or improved (Figure 4B). We chose the fixed-effect model as there was no substantial heterogeneity in the study (I 2 = 36%).…”

“…The pooled analysis showed nonsignificant changes of QoL between the group receiving biofeedback as an add on to PFMT compared to conventional PFMT therapy (without biofeedback) and/or BT lifestyle modification as a control group (MD: 0.13, 95% CI: −7.87 to 8.12, p = 0.98). Three studies 13,21,23 with 161 participants from both the ES (n = 81) and control (n = 80) groups reported changes in QoL after the treatment shown in Figure 2B. The studies were also divided into two subgroups based on the questionnaire that was used.…”

“…The fixed-effect model was selected due to nonsignificant heterogeneity in the study (I 2 : 0%). Figure 3B demonstrates three studies 12,21,23 including 104 participants which were allocated into the ES group (n = 52) and the control group (n = 52) and describes the frequency of incontinence experienced. The pooled analysis indicates that there was a significant difference between both groups of treatment in terms of incontinence episodes that occurred (MD: −1.33, 95% CI: −2.50 to −0.17, p = 0.02).…”

Efficacy of intravaginal electrical stimulation with different treatment frequency in women with refractory idiopathic overactive bladder

“…According to the European Association Urology Guidelines, ES may improve urinary incontinence compared to sham treatment in adults with urinary incontinence (3). The duration of IVES programs varied from 4 weeks to 6 months in women with idiopathic OAB in the literature, although IVES was applied for 4-12 weeks commonly in practice (4)(5)(6)(7)(8)(9)(10)(11). In most studies, IVES was applied 2-3 times a week (4)(5)(6)(7)(8)(9)(10)(11), whereas it was applied more frequently in fewer studies (12)(13)(14).…”

“…The duration of IVES programs varied from 4 weeks to 6 months in women with idiopathic OAB in the literature, although IVES was applied for 4-12 weeks commonly in practice (4)(5)(6)(7)(8)(9)(10)(11). In most studies, IVES was applied 2-3 times a week (4)(5)(6)(7)(8)(9)(10)(11), whereas it was applied more frequently in fewer studies (12)(13)(14). Despite that, no randomized study compared the different IVES treatment frequencies in women with idiopathic OAB, and thus, there is no evidence for which frequency of treatment is the most effective one.…”