Preliminary Results of the Effect of Extracorporeal Magnetic Stimulation on Urinary Incontinence after Radical Prostatectomy: A Pilot Study

Abstract

Introduction: Radical prostatectomy is a common procedure for the treatment of clinically localized prostate cancer. However, urinary incontinence is a significant potential source of morbidity following surgery. Extracorporeal magnetic stimulation (ExMS) is a new technology used for pelvic muscle strengthening in the treatment of stress urinary incontinence. We investigated the clinical effects of ExMS on urinary incontinence after retropubic radical prostatectomy. Patients and Methods: Ten patients who had suffered from urinary incontinence for more than 12 months following radical prostatectomy were enrolled in this study. The Neocontrol system was used. Treatment sessions were for 20 min, twice a week for 2 months. The frequency of the pulse field was 10 Hz for 10 min, followed by a second treatment at 50 Hz for 10 min. Objective and subjective measures included voiding diaries, 1-hour pad weight testing, and a quality of life survey at 1, 2, 3, and 6 months after starting the treatment. Urodynamic studies were performed before and after treatment. Results: Three patients became dry (30%), 3 patients improved (30%), and 4 patients showed stationary symptoms (40%). In the 1-hour pad weight testing, the mean pad weight decreased from 25 to 10.3 g, and the quality of life scores had improved from 70.5 to 84.9 2 months after treatment. The frequency of leak episodes per day was reduced from 5.0 times before to 1.9 times after treatment. In the urodynamic study, mean maximum cystometric capacity and Valsalva leak point pressure increased from 197 ± 53.2 to 309 ± 85.3 ml and from 67.3 ± 22.6 to 97.1 ± 22.7 cm H₂O after treatment, respectively (p < 0.05). 3 of 6 patients who showed improvement returned to the baseline values within 12 months after treatment and requested maintenance ExMS therapy. No side effects were observed. Conclusions: ExMS therapy offered a new option for urinary incontinence treatment after radical prostatectomy. Further studies are required to determine how long the benefits of treatment last and whether maintenance therapy is necessary.

Impact of Sacral Surface Therapeutic Electrical Stimulation on Early Recovery of Urinary Continence after Radical Retropubic Prostatectomy: A Pilot Study

“…Many efforts, including neuromodulation, have been made to achieve early urinary continence. Yokoyama et al reported that extracorporeal magnetic stimulation improved continence in 60% of patients with PPI [9, 10]. On the other hand, two randomized control studies failed to show an additional effect of neuromodulation for PPI compared with PME alone [7, 8].…”

“…These methods were used to treat postprostatectomy incontinence (PPI) [7–10]. A certain effect was observed in these studies, while these studies were applied only for patients with urinary incontinence.…”

Efficacy of perineal electrical stimulation in men with urinary incontinence after radical prostatectomy. A prospective randomized controlled trial

“…It was used “incontinence episodes” from data collected with a 3‐day bladder diary. Men with a 50% or greater reduction in incontinence episodes were considered improvements 14 . The Quality of Life‐Incontinence Impact Questionnaire (IIQ7) was used to assess specific QoL related to incontinence 15 .…”

“…Men with a 50% or greater reduction in incontinence episodes were considered improvements. 14 The Quality of Life-Incontinence Impact Questionnaire (IIQ7) was used to assess specific QoL related to incontinence. 15 Higher scores indicate worse incontinence-related QoL.…”

Rehabilitation Therapy and Urinary Incontinence after Radical Retropubic Prostatectomy

“…The promising role of ExMS on urinary incontinence after radical prostatectomy has been recently pinpointed by Yokoyama et al [43] , who found effi cacy of ExMS therapy from subjective and objective points of view, even if their series was small and a control group was missing. They then suggest the need of properly designed placebo-controlled studies to further determine the efficacy of this treatment, how long its benefi ts last and whether maintenance is necessary.…”