The first experience of using a low-intensity traveling pulsed magnetic field in patients with prostate cancer with urinary incontinence after radical prostatectomy

Abstract

BACKGROUND: To date, there are few studies in the literature that have examined the efficacy of extracorporeal magnetic stimulation alone for urinary incontinence in patients after radical prostatectomy. AIM: The purpose of the study is to obtain preliminary data on the effectiveness and safety of a low-frequency low-intensity traveling pulsed magnetic field in patients with long-term urinary incontinence after radical prostatectomy. MATERIALS AND METHODS: 22 patients (mean age is 66.3±6.8 years) with stage TI-IIIAN0M0 prostate cancer were observed. To assess the type and degree of urinary incontinence, urination diaries, a cough test, a 24h pad-test, the number of nocturnal mictions, and the OAB-q SF questionnaire were analyzed. Patients were divided into 2 comparable groups: 1 (main group) ― a combination of exercises for the pelvic floor muscles and a local pulsed magnetic field, 2 (control group) ― exercises for the pelvic floor muscles, a rehabilitation course of 10 days. RESULTS: All patients showed a stressful form of urinary incontinence. Mild urinary incontinence was observed in 75% of patients in group 1 and in 70% of patients in group 2; moderate urinary incontinence was observed in 25% and 30% of the group, respectively. 50% of patients suffered from nocturia. According to the OAB-q SF questionnaire, there were no statistically significant differences between patients in both groups: 8.1±1.6 points versus 8.0±1.5 points (p=0.9), respectively. As a result of the rehabilitation course, the cough test remained positive in 66.7% of patients in the main group and in 80% of patients in the control group. According to this indicator, the combined method of rehabilitation was more effective than exercise therapy by 13.3%. Nocturia stopped in half of the patients in the main group and in 10% of the patients in the control group. The overall incidence of urinary incontinence episodes decreased in 75% of patients in the main group and in 40% of patients in the control group. The effectiveness of the combined rehabilitation method was 35%. The OAB-q SF questionnaire showed no statistically significant differences between the groups: 6.2+0.9 and 6.9+1.3 points (p=0.8), respectively. CONCLUSION: Local traveling pulsed magnetic field increases the effectiveness of therapeutic exercises in rehabilitation of patients with long-standing urinary incontinence after radical prostatectomy. The obtained data can serve as a basis for further well-organized studies on a larger number of patients allowing to make unambiguous conclusions.