title: Long-term sacral magnetic stimulation for refractory stress urinary incontinence.
abstract: OBJECTIVE
  To evaluate the effects of sacral magnetic stimulation (SMS) on functional and urodynamic improvement in patients with refractory stress urinary incontinence (SUI).
  
  
  METHODS
  A sham-controlled, double-blind, parallel study design with a 4.5-month follow-up.
  
  
  METHODS
  A tertiary hospital.
  
  
  METHODS
  Women (age, 45-75y) with SUI refractory to first-line management (N=34) were allocated to either an experimental (n=20) group or a sham (n=14) group.
  
  
  METHODS
  The SMS protocol consisted of 5-Hz, 20-minute treatments administered over the bilateral third sacral roots, with the intensity set at approximately 70% of the maximal output, for 12 consecutive weekdays.
  
  
  METHODS
  Urodynamic assessments and 2 life stress questionnaires, namely, the Urge-Urinary Distress Inventory (U-UDI) and the Overactive Bladder Questionnaire (OAB-q), were administered pre- and post-SMS intervention. We administered the U-UDI (primary outcome measure) and the OAB-q at 3-week intervals during the follow-up period until 18 weeks after the final intervention.
  
  
  RESULTS
  The experimental group exhibited significant improvements in both U-UDI and OAB-q scores postintervention (P=.011-.014) and at follow-up visits (P<.001-.007) compared with the sham group. In addition, significant increases in bladder capacity, urethral functional length, and the pressure transmission ratio (P=.009-.033) were noted postintervention. Multivariate regression analysis revealed that patients with more severe symptoms benefited more from SMS. A poorer baseline U-UDI score and a shorter urethral functional length were associated with a greater response to SMS.
  
  
  CONCLUSIONS
  Our observations of a greater response to SMS in patients with more severe SUI than in those with mild symptoms, as well as the long-term benefits of the treatment, confirm the efficacy of SMS in treating SUI.
authors: Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Po-Yi
authors: PY
authors: Tsai
authors: Department of Emergency, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Chih-Pin
authors: CP
authors: Wang
authors: Department of Emergency, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Chin-Yi
authors: CY
authors: Hsieh
authors: Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yun-An
authors: YA
authors: Tsai
authors: Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan.
authors: Shih-Ching
authors: SC
authors: Yeh
authors: Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: tychuang@vghtpe.gov.tw.
authors: Tien-Yow
authors: TY
authors: Chuang
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012445:Sacrococcygeal Region; D012720:Severity of Illness Index; D013126:Spinal Nerve Roots; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D014563:Urodynamics
keywords: Magnetic stimulation therapy; Quality of life; Rehabilitation; Treatment; Urinary incontinence; Urodynamics