Randomized, double-blind study of electrical stimulation for urinary incontinence due to detrusor overactivity

• Published in: Urology (Ridgewood, N.J.) Vol. 55; no. 3; pp. 353 - 357
• Main Authors: Yamanishi, Tomonori, Yasuda, Kosaku, Sakakibara, Ryuji, Hattori, Takamichi, Suda, Shin
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2000; Elsevier Science
• Subjects: Adult; Aged; Biological and medical sciences; Diseases of the urinary system; Double-Blind Method; Electric Stimulation Therapy - adverse effects; Female; Humans; Male; Medical sciences; Middle Aged; Muscle Contraction; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Urinary Bladder - physiopathology; Urinary Incontinence - etiology; Urinary Incontinence - physiopathology; Urinary Incontinence - therapy; Human; Urinary system disease; Instrumentation therapy; Activity; Increase; Urinary tract disease; Urinary incontinence; Galvanic vestibular test; Voiding dysfunction; Randomization; Detrusor muscle; Double blind study; Clinical trial; Bladder disease
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(99)00476-8

Objectives. To evaluate the usefulness of electrical stimulation for urinary incontinence due to detrusor overactivity in a randomized, double-blind manner. Methods. Sixty-eight patients (29 men, 39 women, 70.0 ± 11.2 years) were studied. Detrusor overactivity was urodynamically defined as involuntary detrusor contractions of more than 15 cm H 2O during the filling phase. Ten-hertz square waves of 1-ms pulse duration were used. A vaginal electrode was used in the women and an anal or surface electrode in the men. The stimulation was given for 15 minutes twice daily for 4 weeks. The efficacy was evaluated on the basis of a frequency/volume chart and urodynamic study before and after treatment. Results. Thirty-two patients in the active group and 28 in the sham group completed the study. The patient impressions were very good or good in 59% and 39% of the active and the sham group, respectively ( P = 0.0354). On the cystometrogram, the bladder capacity at the first desire to void and the maximum desire to void increased significantly ( P = 0.0104 and P = 0.0046, respectively) in the active group, but not in the sham group. Seven patients in the active group and 1 patient in the sham group were cured ( P = 0.0324); 26 patients (81.3%) in the active group and 9 (32.1%) in the sham group improved ( P = 0.0001). Of 17 patients in the active group, 13 remained cured or improved for an average of 8.4 months after completion of the 4-week treatment; in the sham group, 3 of 6 patients were cured or improved for an average of 4.7 months after completion of the 4-week treatment. Conclusions. Electrical stimulation was useful in treating urinary incontinence due to detrusor overactivity.