Does electrical stimulation of the pelvic floor make any change in urodynamic parameters? When to expect a cure and improvement in women with stress urinary incontinence?
ABSTRACT Our study aimed at determining the effects of pelvic floor electrical stimulation assessed by the number of leakages per day recorded in a voiding diary over 90 days of treatment and urodynamic parameters.
This prospective study was carried out with 34 patients presenting stress urinary incontinence who were treated and evaluated by voiding diaries and urodynamic tests. The primary outcome measure was the number of leakages during the 90 days of treatment. Urodynamic tests were performed before and after treatment.
In our series, average and maximum flow rates and residual urine volume were within normal range in all subjects before and after treatment. Maximum urethral closure pressure and functional profile length on urethral pressure profiles did not change after treatment. In the cystometry, bladder capacities at the first (p < 0.0082) and maximum sensations (p < 0.01) improved significantly after treatment. During the 90 days of treatment, we observed a gradual drop in the number of leakages. This decrease began around day 22. It dropped in half around day 45, tending to zero close to day 90 of treatment (p < 0.01).
The number of incontinent leakage dropped to half around the 8th week, and on average, there was a tendency of the patients to be cured after the 12th week of treatment. At urodynamic studies we observed a significant increase in bladder capacity at the first desire to void and in the maximum cystometric capacity.
Full-textDOI: · Available from: Rodrigo Castro, Mar 23, 2014
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ABSTRACT: Women's sexual dysfunctions (WSD) have been commonly associated with urinary incontinence (UI). Women with UI and who scored low on the Female Sexual Function Index (FSFI) showed an improvement in urinary leakage and also in their sexual life following treatment by transvaginal electrical stimulation (TES). To determine the effects of TES in 37 women complaining of UI, of whom 23 also had WSD, and to compare the FSFI scores of women with UI and 43 women not affected by UI who underwent routine urologic evaluation. Thirty-seven women complaining of UI were evaluated by voiding diary and with FSFI before and after 3 months of TES. All had a urogynecologic evaluation and urodynamic study. In the voiding diary the women reported the types of liquid they ingested, urinary frequency, and episodes of urgency and urine leakage. The domain scores of the FSFI, including desire, arousal, lubrication, orgasm, satisfaction, and pain, were calculated. TES was conducted for 15-30 minutes, twice a week for 3 months, using biphasic intermittent current with a frequency of 50 Hz for stress UI (SUI) and 20 Hz for urge UI (UUI), and the most tolerable intensity of stimulation. After TES, only two of the 10 women with UUI experienced a few leakage incidents; patients with SUI were completely dry during TES; and only three reported a few episodes of UI during intense activities. The five patients with mixed UI improved mainly as regards urgency. The FSFI scores of patients complaining of UI showed significantly lower desire and sexual satisfaction, and higher sexual pain than controls. After 3 months, the 23 women affected by WSD, of the 37 participants with UI, reported a remarkable improvement in their sexual life. TES was found to be a safe and effective therapy for selected patients affected by mild to moderate UI. Because women with UI also complain of WSD compared with the general female population, an investigation of female sexuality is suggested for these patients.Journal of Sexual Medicine 06/2007; 4(3):702-7. DOI:10.1111/j.1743-6109.2006.00318.x · 3.15 Impact Factor
- Femina: revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 12/2008; 36(12):737.
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ABSTRACT: We sought to analyze the effects of electrical stimulation (ES) of the pelvic floor on the bladder of rats. Forty rats were studied and divided into the following groups: GI (control group) - did not receive ES, GII (placebo) - did not receive ES but had an electrode inserted into the vagina; GIII - underwent six sessions of ES of the pelvic floor and GIV - rats that underwent 12 sessions of ES. Subsequently, the bladder was removed and the epithelium, muscle and blood vessels were analyzed. The muscle wall in GIV had increased thickness when compared to other groups. Further, the number of blood vessels was similar in GIII and GIV, which was higher than that found in GI and GII. Finally, there was an increase in the relative percentage of muscle fibers in relation to collagen for GIV compared to GI. After 12 sessions of ES in rats the muscle layer, the number of blood vessels and the relative percentage of muscle fibers were increased.Revista da Associação Médica Brasileira 02/2011; 57(1):20-4. DOI:10.1590/S0104-42302011000100010 · 0.93 Impact Factor