A double‐blind randomized controlled trial of electromagnetic stimulation of the pelvic floor vs sham therapy in the treatment of women with stress urinary incontinence

Gilling, Peter; Wilson, L.; Westenberg, Andre M.; McAllister, William J.; Kennett, Katie M.; Frampton, Christopher; Bell, Deborah F.; Wrigley, Patricia M.; Fraundorfer, Mark R.

doi:10.1111/j.1464-410x.2008.08329.x

Cited by 65 publications

(86 citation statements)

References 20 publications

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“…Gilling et al 4 described the use of this technique to stimulate S-3 nerve roots bilaterally via their sacral foramina to reduce idiopathic bladder hyperactivity. However, no study has determined the functional variability of sacral roots.…”

Section: Discussionmentioning

confidence: 99%

Functional variability of sacral roots in bladder control

Carlucci

Wavasseur

Bénard

et al. 2014

SPI

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Object Sacral roots are involved in sensory, autonomic, and motor innervation of the lower limbs and perineum. Theoretically, it can be assumed that the S-3 root level innervates the bladder; however, clinical practice shows that this distribution can vary. Few researchers have studied this variability. Methods The authors conducted a retrospective study involving 40 patients who underwent surgery requiring an electrophysiological exploration of the sacral roots. They performed stimulations for the monitoring of muscular (3 Hz, 1 V) and bladder responses under cystomanometry (30 Hz, 10 V). Results Although the S-3 roots were involved in bladder innervation in all cases, they were exclusively involved (i.e., the only nerve roots involved) in only 8 of 40 cases. In the remaining 32 cases, other sacral nerve roots were involved. The most common association was S-3+S-4 (12 cases), followed by S-2+S-3 (6 cases), S-2+S-3+S-4 (5 cases), and S-3+S-4+S-5 (2 cases). Stimulation of S-2 could sometimes induce bladder contraction (15 cases, 40%); however, the amplitude was often low. S-4 nerve roots were involved in 24 of 40 cases (60%) in the bladder motor function, whereas S-5 roots were only involved 7 times (17%). Occasionally, we noticed a horizontal asymmetry in the response, with a predominant response from the right side in 6 of 7 cases, always with a major S-3 response. Conclusions This is the first study showing a significant horizontal and vertical variability in the functional distribution of sacral roots in bladder innervation. These results show the variability of cauda equina syndromes and their forensic implications. These data should help with the monitoring of sacral roots and the performance of several tasks during surgery, including neurostimulation and neuromodulation.

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Section: Discussionmentioning

confidence: 99%

Functional variability of sacral roots in bladder control

Carlucci

Wavasseur

Bénard

et al. 2014

SPI

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“…Several early uncontrolled trials reported efficacy in urinary incontinence treatment, with improvement rates from 35% to 70%, 21,22 whereas in controlled trials the results were conflicting 14,23 and no additional benefit over PFMT was demonstrated. 24,25 The lack of evidence is compounded by differences in stimulation parameters and duration of treatment. Women with SUI who are having difficulties to correctly perform PFMT may benefit from a device which directly stimulates contraction of the pelvic floor.…”

Section: Electrical Stimulationmentioning

confidence: 99%

Conservative treatment for female stress urinary incontinence:

Friedman

2013

CUAJ

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“…Nie można pominąć treningu skupionego na długiej kontrakcji mięśni (stymulacja włó-kien S). Wykazano, że stymulacja mięśni dna miednicy zwiększa liczbę włókien mięśniowych typu S w okolicy okołocewkowej [29,30]. Nie zaleca się stosowania elektrostymulacji u pacjentów zdolnych do wolicjonalnego skurczu mięśni dna miednicy [6].…”

Section: Elektrostymulacjaunclassified

Physiotherapy treatment of urinary stress incontinence in women. Part 2

Kwaśna¹,

Chmielewska²,

Piecha³

et al. 2012

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StreszczenieObecnie poszukuje się nowoczesnych, bardziej atrakcyjnych metod leczenia zachowawczego wysiłkowego nietrzymania moczu. Uwagę autorów skupiła nowa forma rehabilitacji i fitness, jaką jest trening wibracyjny. Platformy wibracyjne są wyposażeniem klubów fitness, sal treningowych i gabinetów rehabilitacji. Literatura donosi o zwiększeniu siły i mocy mechanicznej mięśni pod wpływem treningu wibracyjnego. Istnieją podstawy naukowe, aby zakładać korzystny wpływ tej formy treningu na mięśnie dna miednicy. Aspekt ten wymaga jednak weryfikacji.Konwencjonalną metodą leczenia nietrzymania moczu jest elektrostymulacja. Istnieją liczne dowody potwierdzające skuteczność elektroterapii we wzmacnianiu mięśni dna miednicy.Możliwość stosowania prezentowanych metod uzależniona będzie od wieku i ogólnej kondycji fizycznej kobiet z wysiłkowym nietrzymaniem moczu.Słowa kluczowe: wysiłkowe nietrzymanie moczu, wibracja całego ciała, elektrostymulacja. SummaryNowadays, modern and more attractive methods of conservative treatment of urinary stress incontinence are sought. Authors' attention has focused on vibration training which is a new form of rehabilitation and fitness. Fitness centers, training rooms and rehabilitation centers are equipped with vibration platforms. The literature reports an increase in muscle strength and mechanical power as a result of vibration training. There are scientific rationales for assuming a positive impact of this form of training on the pelvic floor muscles. However, this aspect requires verification.Electrical stimulation is a conventional method of treatment of urinary stress incontinence. There has been good evidence for effectiveness of electrotherapy in strengthening of the pelvic floor muscles.The possibility of applying these methods depend on the age and general physical condition of women with urinary stress incontinence.

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A double‐blind randomized controlled trial of electromagnetic stimulation of the pelvic floor vs sham therapy in the treatment of women with stress urinary incontinence

Cited by 65 publications

References 20 publications

Functional variability of sacral roots in bladder control

Functional variability of sacral roots in bladder control

Conservative treatment for female stress urinary incontinence:

Physiotherapy treatment of urinary stress incontinence in women. Part 2

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