Electrical stimulation improves symptoms, QoL in stress urinary incontinence

Research from Brazil shows that both surface and intravaginal electrical stimulation (ES) can improve symptoms and quality of life (QoL) in women with stress urinary incontinence (SUI).

The research team says that the findings suggest that surface ES is an effective option for SUI and may be preferable to intravaginal ES as it is cheaper, simpler to use, and less invasive.

“[Intravaginal] ES is a very invasive treatment in the patient’s perception, decreasing the acceptance and adherence to use of this treatment,” comment Grasiéla Correia (Federal University of Sao Carlos) and colleagues.

They randomly assigned 45 women (mean age 61.5 years) to receive 12 sessions of surface ES or intravaginal ES, or to the control group who received no treatment.

Patients in both active treatment groups had a significant improvement in urinary leakage from baseline, as measured by the 1-hour pad test, while there was no change in the control group, and both treatment groups had significantly lower urinary leakage than the control group.

Pelvic floor muscle strength also significantly improved from baseline in the intravaginal ES group, but there was no significant difference between the three groups. There were also significant increases in pelvic floor muscle pressure in both active treatment groups but, again, no significant differences between the three groups.

Using the King’s Health Questionnaire, the team also found improvements in multiple QoL domains. Compared with the control group, patients in both treatment groups had significant changes with regard to incontinence impact, limitations of daily activities, physical limitation, social limitation, emotion, sleep and disposition, and severity domains.

Writing in the European Journal of Obstetrics & Gynecology and Reproductive Biology, Correia and colleagues say that theirs is only the second study to assess urinary leakage with the 1-hour pad test after surface ES, and the first to directly compare surface with intravaginal treatment.

“Although this is a preliminary study that compares the [surface] ES with the [intravaginal] ES, it opens a new line of possibilities for further studies,” they write.

“Future research should include a follow-up period, urodynamic examination and the use of electromyography.”

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