TENS effective for poststroke urinary incontinence

By Joanna Lyford, Senior medwireNews Reporter

Transcutaneous electrical nerve stimulation (TENS) is effective for improving symptoms and enhancing quality of life in people who develop incontinence following a stroke, research suggests.

Urinary incontinence is a common complication of stroke and is a known predictor of poststroke prognosis. In this study, researchers led by Yun-fei Xu (Shanghai Tenth People’s Hospital, China) evaluated the utility of TENS for poststroke urinary symptoms.

They recruited 61 patients who were hospitalised following either ischaemic or haemorrhagic stroke and randomly assigned them to receive usual care with or without TENS.

TENS was delivered for 30 minutes once a day for 60 days, with a pulse duration of 70 µS, frequency of 75 Hz and maximum therapeutic current of 16 mA. The electrodes were placed on the second lumbar spinous process and the inside of the middle and lower third of the junction between the posterior superior iliac spine and the ischia node.

Efficacy was assessed using the overactive bladder symptom score (OABSS). At baseline, mean scores in both groups were 2.00, 3.00, 5.00 and 4.02 for daily micturitions, nocturia, urgent urination and urge urinary incontinence (UUI), respectively.

After 60 days of treatment, patients in the TENS group showed significant improvements in all four domains of the OABSS. Mean scores fell to 0.67 for daily micturitions, 1.13 for nocturia, 2.64 for urgent urination and 1.61 for UUI.

By contrast, patients given usual care showed no significant improvement in any of the OABSS domains.

Further analysis showed that no patient in the TENS group experienced a significant adverse effect and that TENS was associated with significant improvements in self-care activities of daily living such as use of the toilet, bathing, mobility and stairs. At 60 days, the Barthel Index score was greater than 50 (indicating a high level of independence) in 65.6% of patients in the TENS group versus just 34.5% of patients given usual care.

“This clearly showed that TENS improved poststroke incontinence symptoms and activities of daily life”, write the study authors in Clinical Interventions in Aging.

Finally, urodynamic evaluation revealed that TENS was associated with a significant improvement in maximum cystometry volume and flow rate, and pressure of detrusor at the end of the filling phase.

The researchers conclude: “TENS can be recommended in this clinical condition; however, more studies with a larger sample size and longer follow-up are mandatory to validate the study results.”

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