The Effect of Neuromuscular Electrical Stimulation Therapy On Stress Urinary Incontinence Recurrence: A Randomized Prospective Study

The urinary incontinence poses a health problem in community. The standard care for stress urinary incontinence (UI) is surgical therapy. However there are several methods for prevetion of UI recurrence in these patients. Here, we aimed to evaluate the effect of functional electrical stimulation therapy on stress urinary incontinence recurrence in the postoperative period. Patients who had stress UI and underwent anti-incontinence surgery in our University‟s Hospital Gynecology Department were randomly divided into two groups. The group 1 received postoperative electrical stimulation of pelvic floor muscles twice in a week (30 minutes) for 4 weeks plus Kegel‟s exercise and group 2 received only postoperative Kegel‟s exercise for prevetention of UI recurrence. After completion of therapy, the patients were assesed for urinary recurrence by Wagner‟s Quality of Life scores Turkish version, pad test and urinary diary. A total of 48 patients were included in the study. All patients had anti-incontinence surgery of which 39 had transvaginal tape (TVT), 7 had transobturator tape (TOT) procedure an 2 had Burch colposuspension. The main predominant diagnosis was Stress UI in all cases. 20 patients included in group 1 and underwent electrical stimulation with Kegel‟s exercise and 28 patients included in group 2 which had only Kegel‟s exercise in postoperative period of one month. The demographic characteristic in terms of age, body mass index, gravidity, parity and co-morbid disease did not show any statistical difference(P>0.05). The rate of recurrence in UI was significantly lower in Group 1 than Group 2, respectively (2/20, 10% vs 5/28, 17.8%, p

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1. P. Abrams, L. Cardozo, A. Wagg, and A. Wein, Incontinence, ICI-ICS: International Continence Society, Bristol, UK, 6th edition, 2017.

2. Horng SS, Huang N, Wu SI, et al. The epidemiology of urinary incontinence and it‟s influence on quality of life in Taiwanese middleaged women. Neurourol Urodyn 2013; 32: 371- 376.

3. Mo kinen JI, Gro nroos M, Kiilholma PJA et all: The prevalence of incontinence in a randomised population of 5247 adult Swedish women. Int Urogynecol J 1992; 3: 110-113.

4. Hunskaar S, Burgio K, Clark A, et al. Epidemiology of urinary (UI) and faecal (FI) incontinence and pelvic organ prolapse (POP). WHO- ICS International Consultation on Incontinence. 3rd ed. Paris: Health Publications Ltd; 2005.

5. Huang ZM, Xiao H, Ji ZG, Yan WG, Zhang YS. TVT versus TOT in the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Ther Clin Risk Manag 2018; 14: 2293‐2303.

6. Weber-Rajek M, Strączyńska A, Strojek K, et al. Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial. Biomed Res Int 2020; 2020: 1019872.

7. Nambiar A. K., Bosch R., Cruz F. et al., “EAU guidelines on assessment and nonsurgical management of urinary incon- tinence,” European Urology, vol. 2018; 73: 596-609,

8. Green RJ, Laycock J. Objective methods for evaluation of interferential therapy in the treatment of incontinence. IEEE Trans Biomed Eng 1990; 37: 615-623.

9. Shamliyan TA, Kane RL, Wyman J, et al. Systematic review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med 2008; 148: 459-473.

10. Maher RM, Caulfield B. A novel externally applied neuromuscular stimulator for the treatment of stress urinary incontinence in women--a pilot study. Neuromodulation 2013; 16: 590‐594.

11. Wagner TH, Patrick DL, Bavendam TG, Martin ML, Buesc-hing DP: Quality of life of persons with urinary incontinence: Development of a new measure. Urology 1996; 47: 67-72.

12. O‟Sullivan R, Karantanis E, Stevermuer TL, et al. Definition of mild, moderate and severe incontinence on the 24-hour pad test. BJOG 2004; 111: 859-862.

13. Ashton-Miller JA, Howard D, DeLancey JO. The functional anatomy of the female pelvic floor and stress continence control system. Scand J Urol Nephrol Suppl 2001; 207: 1-7.

14. Bø K, Talseth T, Holme I. Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ 1999; 318: 487-493.

15. Sand PK et al. Pelvic floor electrical stimulation in the treatment of genuine stress incontinence: a multicenter, placebo-controlled trial. Am J Obstet Gynecol 1995; 173: 72-79.

16. Xu H, Liu B, Wu J, et al. A Pilot Randomized Placebo Controlled Trial of Electroacupuncture for Women with Pure Stress Urinary Incontinence. PLoS One 2016; 11: 0150821.

17. Wallis MC, Davies EA, Thalib L, Griffiths S. Pelvic static magnetic stimulation to control urinary incontinence in older women: a randomized controlled trial. Clin Med Res 2012; 10: 7‐14.

18. He Q, Xiao K, Peng L, et al. An Effective Meta-analysis of Magnetic Stimulation Therapy for Urinary Incontinence. Sci Rep 2019; 9: 9077.

19. Karan A, Aksaç B, Ayyıldız H, et al. Üriner inkontinanslı hastalarda yaşam kalitesi ve objektif değerlendirme parametreleri ile ilişkisi. Turkish Journal of Geriatrics. Geriatri 2000; 3: 102-106
Eastern Journal of Medicine-Cover
  • ISSN: 1301-0883
  • Başlangıç: 1996
  • Yayıncı: ERBİL KARAMAN