Evaluation of the subjective and objective effect of maximal electrical stimulation in patients complaining of urge incontinence.

S Kulseng-Hanssen, M Kristoffersen, E Larsen
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Abstract

Background: Favorable results have been reported following Maximal Electrical Stimulation (MES) of patients with urgency and urge incontinence. However, patient groups have often been mixed and outcome measures poorly defined. We therefore wanted to treat a homogeneous patient population with MES and evaluate the effect by defined subjective and objective outcome measures.

Methods: Eighteen female patients complaining of urge incontinence had MES performed. Before and 3 months after MES, the patients performed a 24 hour micturition chart and pad test. They indicated on a visual analogue scale their subjective degree of urgency and leakage and had an ambulatory urodynamic monitoring performed. Nine months after MES the patients were asked whether their urge incontinence was less, equal or more troublesome than before MES.

Results: After MES the patients indicated significantly less urgency and leakage. A significant difference was not found in any of the objective outcome measures after MES. Six out of 18 patients (33%) found their urge incontinence less troublesome 9 months after MES, while 12 (66%) found it unchanged or more troublesome than before.

Conclusions: Significantly subjective effect was found following MES. However, none of the objective outcome measures were significantly improved. We were disappointed by the results and have stopped using the method.

最大电刺激对急迫性尿失禁患者主客观效果的评价。
背景:最大电刺激(MES)治疗急迫性和急迫性尿失禁的疗效良好。然而,患者群体往往是混合的,结果测量不明确。因此,我们希望治疗同质的MES患者群体,并通过定义的主观和客观结果测量来评估效果。方法:对18例以急迫性尿失禁为主诉的女性患者行MES。MES前后3个月分别行24小时排尿图和尿垫试验。他们在视觉模拟量表上表明他们的主观急症和漏尿程度,并进行了动态尿动力学监测。在MES后9个月,患者被问及他们的急迫性尿失禁是否比MES前更少,相同或更麻烦。结果:经MES后患者急症和漏尿明显减少。MES后的任何客观结果测量均未发现显著差异。18例患者中有6例(33%)在MES后9个月发现急迫性尿失禁症状减轻,而12例(66%)发现急迫性尿失禁症状没有变化或比以前更严重。结论:MES后存在明显的主观效应。然而,没有一项客观结果指标得到显著改善。我们对结果感到失望,已经停止使用这种方法。
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