Electrical control of urinary incontinence: A clinical appraisal

Alexander, Shedden; Rowan, David

doi:10.1002/bjs.1800571017

Cited by 22 publications

(9 citation statements)

References 7 publications

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“…The vaginal electrode is usually tampon or cylinder shaped, and the anal electrode is bullet or hourglass shaped [7,19]. Some reports speculate that anal stimulation is more effective than vaginal [17,19,42,43], but there has been no controlled study comparing their various effects.…”

Section: Internal (Implantable ) Electrodesmentioning

confidence: 97%

“…The advantages of non-implantable electrodes are as follows: they can be used without surgery; application is very simple and can be prescribed by a qualified medical specialist; if continence is achieved after long-term stimulation, the patient can himself remove the entire system; in case of malfunction, the system can be easily removed; power drain is less than that of implantable systems by a factor of 2 or more; the price of a nonimplantable system is much less than that of an implantable one [17].…”

Section: External (Non-implantable) Electrodesmentioning

confidence: 99%

“…Electric pessaries consist of a ring pessary carrying two coil electrodes of stainless steel wire arranged at an angle of 60-70 ~ to the center, and are connected by a flexible cable to a miniature batterypowered generator box carried in an axillary holster [16,17,33,39,[44][45][46]. The pessary is inserted into the vagina so that asymmetrically placed electrodes can be positioned at the anterior, where the strongest contraction is evoked.…”

Section: Electric Pessatmentioning

confidence: 99%

“…Later, the implantable electrodes were sutured to the levator ani muscle using a retropubic approach, or near the pudendal nerves via a perineal approach [17]. The internal pelvic floor stimulator usually consists of an implantable stimulator with two electrodes and an external transmitter.…”

Section: Internal (Implantable ) Electrodesmentioning

confidence: 99%

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Electrical stimulation for stress incontinence

Yamanishi

Yasuda

1998

Int Urogynecol J

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Electrical stimulation has been reported to be effective for stress incontinence, cure and improvement rates being reported to range from 30% to 50%, and from 6% to 90%, respectively. However, clinical application of this treatment is not common because there is little physiological and technical information. Electrodes for electrical stimulation are divided into two types: external (non-implantable) and internal (implantable), and there are two methods of stimulation: chronic (long-term, continuous) and short-term. Frequencies of 20-50 Hz, with a pulse duration of 1-5 ms, have been reported to be effective for urethral closure. The effectiveness of the treatment should be verified with placebo-controlled double-blinded trials, and four such studies using an active and a sham device have been reported. Two of these verified the superiority of the active device over the sham device, but the others did not demonstrate any significant difference between the two with regard to efficacy. Electrical stimulation has been reported to result in a long-term continuation of therapeutic effect. The effect has been explained as a re-education or a reactivation of lost functions of the pelvic floor muscles. As to adverse effects, there may be some complications in relation to anesthesia or surgical procedures, such as infection, pain and bleeding with implantable electrodes. The incidence of adverse effects in short-term electrical stimulation is less than 14%. In conclusion, short-term electrical stimulation using non-implantable anal or vaginal electrodes is the most recommendable because of safety and ease of use.

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Section: Internal (Implantable ) Electrodesmentioning

confidence: 97%

Section: External (Non-implantable) Electrodesmentioning

confidence: 99%

Section: Electric Pessatmentioning

confidence: 99%

Section: Internal (Implantable ) Electrodesmentioning

confidence: 99%

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Electrical stimulation for stress incontinence

Yamanishi

Yasuda

1998

Int Urogynecol J

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“…Among these physical therapy approaches, the use of electrical stimulation with exercise training aims at rapid improvement. Electrical stimulation supports the therapy by strengthening the weak muscle contraction [9,[17][18][19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

The Short-Term Effects of Physical Therapy in Different Intensities of Urodynamic Stress Incontinence

Akbayrak

Yüksel

Demirtürk

2005

Gynecol Obstet Invest

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Purpose: The aim of this study was to investigate and compare the short-term effects of a physical therapy program in patients with different intensities of urodynamic stress urinary incontinence (USI). Subjects and Methods: 48 patients with USI were assigned to three groups according to the intensity of their incontinence: group I: 0–2 g (n = 17), group II (mild intensity: >2–10 g, n = 16) and group III (moderate intensity: >10 g, n = 15) as determined by the 1-hour pad test. A physical therapy program composed of Kegel exercises and interferential current was applied to all patients for duration of 5 weeks, with a total of 15 sessions. The number of pads used a day, frequency of voiding (times/day), amount of urinary leakage according to the 1-hour pad test (mg), severity of complaint (as centimeters on visual analogue scale) and pelvic floor muscle strength (cm Hg) were evaluated. Pre-treatment and post-treatment values of these data were compared in each group and among groups. Results: Analyses of the data indicated that the number of pads used a day, frequency of voiding and amount of urinary leakage decreased and pelvic floor muscle strength increased significantly in each group (p < 0.05). Cure in USI was found in 88% of subjects in group I and 18% of subjects in group II (mild intensity). None of the patients in group III (moderate intensity) showed a cure effect. Conclusion: This physical therapy program was found to be more effective in mild and moderate intensities than severe USI.

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