OBJECTIVE: To evaluate the effects of sacral magnetic stimulation (SMS) on functional and urodynamic improvement in refractory stress urinary incontinence (SUI) patients.
DESIGN: A sham-controlled, double-blind parallel study design with a 4.5-month follow-up.
SETTING: A tertiary hospital.
PARTICIPANTS: Thirty-four female SUI patients (aged 45-75 y) refractory to first-line management were allocated to an experimental group (n = 20) or a sham (n = 14) group.
INTERVENTIONS: 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.
MAIN OUTCOME MEASURES: Urodynamic assessments and 2 life stress questionnaires, namely the Urge-Urinary Distress Inventory (Urge-UDI) and Overactive Bladder Questionnaire (OAB-q), were administered pre- and post-SMS intervention. We administered the Urge-UDI (primary outcome measure) and OAB-q at 3-week intervals during the follow-up period until 18 weeks after the final intervention.
RESULTS: Following the SMS intervention, the experimental group exhibited significant improvements in both Urge-UDI and OAB-q scores postintervention (P = .011-.014), and at the follow-up visits (P < .001-.007) compared with the sham group. In addition, significant increases in bladder capacity, urethral functional length (UFL), 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 Urge-UDI score and a shorter UFL 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.
Written by:
Tsai PY, Wang CP, Hsieh CY, Tsai YA, Yeh SC, Chuang TY. Are you the author?
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University, School of Medicine, Taipei, Taiwan; Department of Emergency, Mackay Memorial Hospital, Taipei, Taiwan; Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan.
Reference: Arch Phys Med Rehabil. 2014 Jul 26. pii: S0003-9993(14)00505-X.
doi: 10.1016/j.apmr.2014.07.010
PubMed Abstract
PMID: 25073008
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