Effectiveness of Magnetic Stimulation in the Treatment of Urinary Incontinence: A Systematic Review and Results of Our Study

Abstract

Urinary incontinence (UI) is becoming an increasingly common health problem. UI treatment can be conservative or surgical. This paper focuses on the effectiveness of magnetic stimulation (MS) in the treatment of UI. We performed a systematic review in order to combine and compare results with results from our clinical study. A clinical prospective non-randomized study was carried out at the Ljubljana University Medical Center’s Gynecology Division. It included 82 randomly selected female patients, irrespective of their UI type. The success rate of using MS in treating UI was based on standardized ICIQ-UI SF questionnaires. Patients completed 10 therapy sessions on MS, and follow-up was performed 3 months after the last therapy session. UI improved after treatment with MS. The ICIQ-UI SF score improved in patients regardless of the type of UI. However, the greatest decrease in post-treatment assessment ICIQ-UI SF scores was seen in patients with stress urinary incontinence (SUI). Based on the findings described above, it can be concluded that MS is a successful non-invasive conservative method for treating UI. Future studies are necessary, all of which should include a large sample size, a control group, an optimal research protocol, pre-treatment analyses, standardization, and longer follow-ups.

A study of flex miniaturized coils for focal nerve magnetic stimulation

“…[22][23][24][25][26][27] MS uses similar TMS devices to target the peripheral nervous system (PNS) or peripheral magnetic stimulation (PMS) for investigational nerve conduction studies, [28][29][30][31] to treat different neurological [32][33][34] and musculoskeletal impairments. [34][35][36][37][38][39][40][41] In a typical PMS session, a standard figure-of -eight or a circular coil is applied over specific muscles or nerves, such as the trapezius and the deltoid, to treat migraine, 34,42,43 or the sacral nerve to treat urinary and fecal incontinence. [44][45][46] Furthermore, PMS is increasingly being studied for stimulating both the spinal root and the peripheral nerve levels in treating neuropathic pain.…”

Efficacy of 3 Tesla Functional Magnetic Stimulation for the Treatment of Female Urinary Incontinence

“…Although the US FDA has approved extracorporeal FMS for UI treatment since 1998, few studies in the literature have assessed the efficacy of safety for this procedure. Lukanovi’c et al [ 8 ], in a recent systematic review on the effectiveness of magnetic stimulation in the treatment of UI, which included articles published between 2010 and 2020, showed that only 12 studies were eligible. These studies, which have mainly considered patients with SUI, used different devices with various magnetic field power (up to a maximum of 2.5 Tesla), different diagnostic methods to define the type and severity of UI and different tools to evaluate outcomes (standardized questionnaires are sometimes used).…”

“…It is based on Faraday’s law of magnetic induction, whereby a time-varying magnetic field induces electrical activity that depolarizes the nerves and causes the pelvic floor muscles to contract or relax. Repeated activation of the terminal motor nerve fibres and the motor end plates tend to build muscle strength and endurance [ 8 , 10 ]. The main stimulation targets are the afferent branches of the pudendal nerve to inhibit the detrusor muscle through central reflexes and the efferent nerve branches to facilitate strengthening of the pelvic floor muscles and increase the tonus of the urethral sphincters, thereby inhibiting the detrusor muscle through the guarding reflex [ 10 ].…”

“…The FMS treatment was administered for 20 min per session, twice per week for a total of 8 weeks. We used specific therapy program for different types of UI as suggested by producers and based on previous experiences [ 8 ] ( Table 1 ). During the treatment session, the electric impulse intensity was adjustable according to the patient’s tolerance.…”

“…In addition, the setting (patient sitting on a chair with clothes) and the lack of direct activation of skin sensory receptors and C-fibres, which can cause pain and discomfort, make this procedure more comfortable than conventional electrical stimulation [ 5 , 7 ]. However, few studies in the literature have assessed the efficacy of this device on female UI treatment, with different protocols and different outcome measures [ 8 ]. Furthermore, the devices used developed dissimilar magnetic field power up to a maximum of 2.5 Tesla.…”