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Treatment of urinary stress incontinence by intravaginal electrical stimulation and pelvic floor physiotherapy

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Abstract

Treatment of urinary stress incontinence (USI) by intravaginal electrical stimulation (IES) and pelvic floor physiotherapy represents an alternative to other therapies. The purpose of this work was to evaluate the effectiveness of this treatment inpatients with urinary incontinence. From January 1998 to May 2000, 30 women (mean age 54 years) were studied. All patients had USI and 70% urge incontinence; average follow-up was 7 months. Selection criteria were based on clinical history, objective evaluation of perineal musculature by perineometry, and urodynamics. The treatment protocol consisted of three sessions of IES per week for 14 weeks using INNOVA equipment. Physiotherapy was initiated in the fifth week of IES. A significant decrease in the number of micturitions and urgency was observed after treatment (P<0.01). The pad test showed a reduction in urinary leakage from 13.9  to 5.9 g after treatment (P<0.01). Objective evaluation of perineal muscle strength showed a significant improvement in all patients after treatment (P<0.01). A positive correlation was observed between maximum flow rate (Qmax) and all three variables: urethral pressure profile at rest and on straining (stop test), and abdominal leak-point pressure (ALPP). A positive correlation was also observed between ALPP and the stop test. Over 100 different surgical and conservative treatments have been tried to manage USI. The majority of these procedures reveal that despite progress already made in this area, there is no ideal treatment. Satisfactory results can be achieved with this method, especially with patients who are reluctant to undergo surgery because of personal or clinical problems.

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Abbreviations

USI:

Urinary stress incontinence

IES:

Intravaginal electrical stimulation

ALPP:

Abdominal leak-point pressure

UPP:

Urethral pressure profile

VLPP:

Valsalva leak-point pressure

BMI:

Body mass index

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Authors and Affiliations

  1. Faculty of Medicine, São Paulo State University (UNESP), CEP: 18618–970 Botucatu, São Paulo, Brazil

    João Luiz Amaro, Mônica O. Oliveira Gameiro & Carlos Roberto Padovani

Authors
  1. João Luiz Amaro
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  2. Mônica O. Oliveira Gameiro
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  3. Carlos Roberto Padovani
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Corresponding author

Correspondence to João Luiz Amaro.

Additional information

Editorial Comment: This study is consistent with previous data in that it demonstrates that intravaginal electric stimulation is a successful treatment modality for stress and urge incontinence. It would be clinically relevant to know how the two groups (50% satisfied vs 50% dissatisfied) differed with regard to their demographics and pretreatment data. Looking at this information, the authors may have been able to comment on what population is less likely to be successful with non-surgical management: this information would be useful in the literature. To detect accurate urinary loss in an urge incontinent patient, a 24-h pad test is important. This may be why the authors did not find a correlation between post-treatment satisfaction and 1-h pad weight test, i.e. the patients were a lot wetter than was detected by the 1-h test.

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Amaro, J.L., Oliveira Gameiro, M.O. & Padovani, C.R. Treatment of urinary stress incontinence by intravaginal electrical stimulation and pelvic floor physiotherapy. Int Urogynecol J 14, 204–208 (2003). https://doi.org/10.1007/s00192-003-1061-4

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  • DOI: https://doi.org/10.1007/s00192-003-1061-4

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