The treatment of urinary incontinence with electrical stimulation in nursing home patients: a pilot study.
OBJECTIVE
To test the effectiveness of electrical stimulation in the treatment of urinary incontinence in female nursing home patients.


METHODS
A community long term care facility.


METHODS
Nine unselected female nursing home patients with urinary incontinence. All patients were moderately to severely cognitively impaired. By bedside cystometry, six patients had involuntary detrusor contractions while two had inconclusive results.


METHODS
Participants were treated with electrical stimulation for 8 weeks using the Microgyn II device. A current with a frequency of 20 hertz and a pulse width of 1 millisecond was delivered repeatedly for 2 seconds on, 4 seconds off for 15 seconds twice a week.


METHODS
The number of every-2-hour wet episodes during a 48-hour period (Wet) was recorded by a blinded observer at baseline and after 4 and 8 weeks of treatment. We evaluated the overall effect of electrical stimulation by averaging the Wet at 4 and 8 weeks for each patient and comparing it to Wet at baseline.


RESULTS
The mean +/- standard deviation of intensity of electrical stimulation was 12 +/- 5 milliamps. Mean Wet at baseline was 11.8 +/- 4.2. For all patients mean Wet increased by 2.3 +/- 3.2, P = 0.07. Analysis of patients with documented involuntary detrusor contractions showed a mean increase in Wet of 2.6 +/- 3.6, P = 0.16. The volume of fluid at which an involuntary contraction occurred during cystometry showed a mean increase of 48.3 +/- 52.6 mL, P = 0.07 after 8 weeks of treatment.


CONCLUSIONS
Electrical stimulation is well tolerated in elderly nursing home patients. However, it was ineffective in improving urinary incontinence. In fact, there was a tendency for the treatment to worsen the incontinence.
Lamhut
P
P
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Jackson
T W
TW
Wall
L L
LL
D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009735:Nursing Homes; D010865:Pilot Projects; D014549:Urinary Incontinence / Q000628:therapy*