title: Effects and indications of sacral surface therapeutic electrical stimulation in refractory urinary incontinence.
abstract: 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.
authors.affiliation: Department of Rehabilitation, Tohoku Bunka Gakuen University, 6-45-1, kunimi, aoba-ku, Sendai 981-8551, Japan. yokozuka@rehab.tbgu.ac.jp
authors.forename: Mieko
authors.initials: M
authors.lastname: Yokozuka
authors.forename: Takashige
authors.initials: T
authors.lastname: Namima
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ichie
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Handa
mesh_terms: 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