Effects and indications of sacral surface therapeutic electrical stimulation in refractory urinary incontinence.
OBJECTIVE
To describe the effects and indications of sacral surface therapeutic electrical stimulation (SS-TES) for refractory urinary incontinence.


METHODS
Evaluation before and after therapy.


METHODS
On clinical site and at nursing home.


METHODS
Seven neurogenic bladder, five unstable bladder and six nocturia cases were investigated. Twelve were outpatients and six were residents.


METHODS
Surface electrodes were placed at the posterior sacral foramens of S2 and S4. Stimulation conditions were duration 0.3 ms, frequency 20 Hz and maximum intensity. The stimulation was continued for 15 min twice daily for over one month.


METHODS
Therapeutic effects were evaluated on the basis of voiding charts as subjective findings and urodynamic study as objective findings before and after therapy.


RESULTS
Subjective findings showed incontinence frequency significantly decreased from 2.3 +/- 1.4 times/day before therapy to 1.3 +/- 2.0 times/day after therapy (p < 0.01); 55.5% of patients were improved or greatly improved. Objective findings showed that maximum vesical capacity (MVC) significantly increased from 208.2 +/- 94.5 ml before therapy to 282.1 +/- 66.8 ml (p < 0.001). Uninhibited contraction significantly decreased from 40.4 +/- 31.4 cmH2O before therapy to 25.7 +/- 23.9 cmH2O (p < 0.01); 44% of patients were improved or greatly improved. This therapy was effective in particular for cases whose MVC was small before applying SS-TES.


CONCLUSIONS
SS-TES was effective in some patients with refractory urinary incontinence.
Yokozuka
Mieko
M
Department of Rehabilitation, Tohoku Bunka Gakuen University, 6-45-1, kunimi, aoba-ku, Sendai 981-8551, Japan. yokozuka@rehab.tbgu.ac.jp
Namima
Takashige
T
Nakagawa
Haruo
H
Ichie
Masayoshi
M
Handa
Yasunobu
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012445:Sacrococcygeal Region / Q000294:innervation*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology; D014549:Urinary Incontinence / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology