Preliminary results of the effect of extracorporeal magnetic stimulation on urinary incontinence after radical prostatectomy: a pilot study.
BACKGROUND
Radical prostatectomy is a common procedure for the treatment of clinically localized prostate cancer. However, urinary incontinence is a significant potential source of morbidity following surgery. Extracorporeal magnetic stimulation (ExMS) is a new technology used for pelvic muscle strengthening in the treatment of stress urinary incontinence. We investigated the clinical effects of ExMS on urinary incontinence after retropubic radical prostatectomy.


METHODS
Ten patients who had suffered from urinary incontinence for more than 12 months following radical prostatectomy were enrolled in this study. The Neocontrol system was used. Treatment sessions were for 20 min, twice a week for 2 months. The frequency of the pulse field was 10 Hz for 10 min, followed by a second treatment at 50 Hz for 10 min. Objective and subjective measures included voiding diaries, 1-hour pad weight testing, and a quality of life survey at 1, 2, 3, and 6 months after starting the treatment. Urodynamic studies were performed before and after treatment.


RESULTS
Three patients became dry (30%), 3 patients improved (30%), and 4 patients showed stationary symptoms (40%). In the 1-hour pad weight testing, the mean pad weight decreased from 25 to 10.3 g, and the quality of life scores had improved from 70.5 to 84.9 2 months after treatment. The frequency of leak episodes per day was reduced from 5.0 times before to 1.9 times after treatment. In the urodynamic study, mean maximum cystometric capacity and Valsalva leak point pressure increased from 197 +/- 53.2 to 309 +/- 85.3 ml and from 67.3 +/- 22.6 to 97.1 +/- 22.7 cm H2O after treatment, respectively (p < 0.05). 3 of 6 patients who showed improvement returned to the baseline values within 12 months after treatment and requested maintenance ExMS therapy. No side effects were observed.


CONCLUSIONS
ExMS therapy offered a new option for urinary incontinence treatment after radical prostatectomy. Further studies are required to determine how long the benefits of treatment last and whether maintenance therapy is necessary.
Yokoyama
Teruhiko
T
Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan. uroyoko@md.okayama-u.ac.jp
Inoue
Miyabi
M
Fujita
Osamu
O
Nozaki
Kunihiro
K
Nose
Hiroyuki
H
Kumon
Hiromi
H
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008280:Magnetics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D010812:Physical Stimulation / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011468:Prostatectomy; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology