Öz
Amaç: Bu çalışmanın amacı, stres üriner inkontinans tanısı almış kadınlarda yeni nesil eksternal elektrik stimülasyonunun inkontinans semptomları üzerine etkisini incelemekti.
Yöntem: Stres üriner inkontinans tanısı alan 13 kadın (yaş: 55,69±8,60 yıl, vücut kütle indeksi: 33,51±4,72 kg/m2) çalışmaya dahil edildi. Pelvik taban kas kuvveti ve enduransı perineometre ile, inkontinans şiddeti 24 saatlik ped testi ile, üriner inkontinansın yaşam kalitesi üzerine algılanan etkisi Vizüel Analog Skalası (VAS, cm) ile ve subjektif iyileşme algısı 4 sorulu likert tipi skala ile değerlendirildi. Tüm ölçümler, tedavi öncesi ve 8 haftalık tedavi sonrası yapıldı. Tedavi olarak, eksternal elektrik stimülasyonu, 8 hafta boyunca haftada 3 gün ve 30 dakikalık seanslar şeklinde uygulandı. Değişkenlerin tedavi öncesi ve tedavi sonrasındaki karşılaştırmaları Wilcoxon testi ile analiz edildi ve istatistiksel anlamlılık düzeyi p<0,05 olarak kabul edildi.
Bulgular: Tedavi öncesi ile karşılaştırıldığında pelvik taban kas kuvvet ve endurans değerinde anlamlı artış, 24 saatlik ped testi miktarı ve üriner inkontinansın yaşam kalitesi üzerine algılanan etkisinde anlamlı iyileşme görüldü (p<0,05). Ayrıca, subjektif iyileşme algısı sonuçlarında bireylerin çoğunluğunun (%92,3) semptomlarının azaldığı ve kendilerini daha iyi hissettikleri belirlendi.
Sonuç: Stres üriner inkontinans tanısı alan bireylerde 2 ay boyunca uygulanan eksternal elektrik stimülasyonunun semptomlarda iyileşme sağladığı fakat tam iyileşme için yetersiz olduğu belirlendi. Daha uzun süreli ve daha büyük örneklemli çalışmalara ihtiyaç vardır.
Anahtar Kelimeler
Stres üriner inkontinans Elektrik stimülasyonu Konservatif tedavi
Kaynakça
- 1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urol. 2003;61:37-49.
- 2. Schmidbauer J, Temml C, Schatzl G, et al. Risk factors for urinary incontinence in both sexes. Eur Urol. 2001;39:565-570.
- 3. Sen I, Onaran M, Tan MO, et al. Evaluation of sexual function in women with overactive bladder syndrome. Urol Int. 2007;78:112-115.
- 4. Oláh KS, Bridges N, Denning J, et al. The conservative management of patients with symptoms of stress incontinence: a randomized, prospective study comparing weighted vaginal cones and interferential therapy. Am J Obstet Gynecol. 1990;162:87-92.
- 5. Milsom I, Altman D, Cartwright R, et al. Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal incontinence (AI). Incontinence: 5th International Consultation on Incontinence, Paris, February 2012.ICUD-EAU, 2013;15-107.
- 6. Dolman M. Electromuscular stimulation for urinary incontinence: Levator 100. Br J Community Nurs. 2000;5:214-219.
- 7. Maher RM, Caulfield B. A Novel Externally Applied Neuromuscular Stimulator for the Treatment of Stress Urinary Incontinence in Women—A Pilot Study. Neuromodulation: Technology at the Neural Interface. 2013;16:590-594.
- 8. Allon EF. The role of neuromuscular electrical stimulation in the rehabilitation of the pelvic floor muscles. Br J Nurs. 2019;28:968-974.
- 9. Correia GN, Pereira VS, Hirakawa HS, et al. Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence:randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2014; 173:113-118.
- 10. Green RJ, Laycock J. Objective Methods for Evaluation of Interferential Therapy in the Treatment of Incontinence. Trans Biomed Eng. 1990; 37:615-623.
- 11. Maher RM, Hayes DM. How Do Pelvic Floor Muscle Contractions Elicited by 2 Different Delivery Methods of Neuromuscular Electrical Stimulation Compare With Volitional Contractions in Supine and Standing in Nulliparous Continent Women? J Womens Health Phys Therap. 2018;42:87-93.
- 12. O’Reilly B, O’Sullivan O, Siddiqui K, et al. Change in quality of life scores in incontinence patients following an intervention of external electrical stimulation as determined by the Kings Health Questionnaire. Continence Foundation of Ireland, Annual Study Day. 2016.
- 13. Kelleher CJ, Pleil AM, Reese PR, et al. How much is enough and who says so? The case of the King's Health Questionnaire and overactive bladder. BJOG. 2004;111:605-612.
- 14. Abdelbary AM, El-Dessoukey AA, Massoud AM, et al. Combined vaginal pelvic floor electrical stimulation (pfs) and local vaginal estrogen for treatment of overactive bladder (OAB) in perimenopausal females. Randomized controlled trial (RCT). Urol. 2015;86:482-486.
- 15. Kaya S, Akbayrak T, Gursen C, et al. Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J. 2015;26:285-293.
- 16. O'sullivan R, Karantanis E, Stevermuer T, et al. Definition of mild, moderate and severe incontinence on the 24‐hour pad test. BJOG. 2004;111:859-862.
- 17. Stach-Lempinen B, Kujansuu E, Laippala P, et al. Visual Analogue Scale, Urinary Incontinence Severity Score and 15 D’Psychometric Testing of Three Different Health-related Quality-of-life Instruments for Urinary Incontinent Women. Scand J Urol Nephrol. 2001;35:476-483.
- 18. Lagro-Janssen A, Debruyne F, Smits A, et al. The effects of treatment of urinary incontinence in general practice. Fam Pract. 1992;9:284-289.
- 19. Dmochowski R, Lynch CM, Efros M,et al. External Electrical Stimulation Compared With Intravaginal Electrical Stimulation for the Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Noninferiority Trial.2019;38:1834-1843.
- 20. Soeder S, Tunn R. Neuromuscular electrical stimulation (NMES) of the pelvic floor muscles using a non-invasive surface device in the treatment of stress UI (SUI); a pilot study. IUGA Poster Presentation Conference; 2013.
- 21. Huebner M, Riegel K, Hinninghofen H, et al. Pelvic floor muscle training for stress urinary incontinence: A randomized, controlled trial comparing different conservative therapies. Physiother Res Int. 2011;16:133-140.
- 22. Lose G, Jørgensen L, Thunedborg P. 24‐Hour Home Pad Weighing Test versus 1‐Hour Ward Test in The Assessment of Mild Stress Incontinence. Acta Obstet Gynecol Scand. 1989;68:211-215.
- 23. Akbayrak T, Yüksel I, Demirturk F. The short-term effects of physical therapy in different intensities of urodynamic stress incontinence. Gynecol Obstet Invest. 2005;59:43-48.
- 24. Delancey JOL. Structural aspects of urethrovesical function in the female. Neurourol Urodyn. 1988;7:509-519.
Öz
Purpose: The aim of this study was to investigate the effect of new generation external electrical stimulation on incontinence symptoms in women with stress urinary incontinence.
Methods: Thirteen patients (age: 55.69±8.60 years, body mass index: 33.51±4.72 kg/m2) with stress urinary incontinence were included in the study. Pelvic floor muscle strength and endurance were evaluated with perineometer, incontinence severity with 24-hour pad test, perceived effect of urinary incontinence on quality of life with Visual Analogue Scale (VAS, cm) and self-reported improvement with using the four-item Likert-type scale. All measurements were performed before and after 8 weeks of treatment. As treatment, external electrical stimulation was performed as 3 days in a week, 30-minute session for 8 weeks. The pre-treatment and post-treatment comparisons of the variables were analyzed with the Wilcoxon test and the statistical significance level was accepted as p<0.05.
Results: Compared with pretreatment, there was a significant increase in pelvic floor muscle strength and endurance value, 24-hour pad test amount and significant improvement in perceived effect of urinary incontinence on quality of life (p<0.05). In addition, self-reported improvement results showed that most of the individuals (92.3%) had reduced symptoms and felt better.
Conclusion: It was determined that external electrical stimulation applied 3 days for 8 weeks in patients with stress urinary incontinence improved symptoms but was insufficient for complete recovery. Studies with longer duration and a larger sample size are needed.
Anahtar Kelimeler
Stress urinary incontinence Electrical stimulation Conservative treatment
Kaynakça
- 1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urol. 2003;61:37-49.
- 2. Schmidbauer J, Temml C, Schatzl G, et al. Risk factors for urinary incontinence in both sexes. Eur Urol. 2001;39:565-570.
- 3. Sen I, Onaran M, Tan MO, et al. Evaluation of sexual function in women with overactive bladder syndrome. Urol Int. 2007;78:112-115.
- 4. Oláh KS, Bridges N, Denning J, et al. The conservative management of patients with symptoms of stress incontinence: a randomized, prospective study comparing weighted vaginal cones and interferential therapy. Am J Obstet Gynecol. 1990;162:87-92.
- 5. Milsom I, Altman D, Cartwright R, et al. Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal incontinence (AI). Incontinence: 5th International Consultation on Incontinence, Paris, February 2012.ICUD-EAU, 2013;15-107.
- 6. Dolman M. Electromuscular stimulation for urinary incontinence: Levator 100. Br J Community Nurs. 2000;5:214-219.
- 7. Maher RM, Caulfield B. A Novel Externally Applied Neuromuscular Stimulator for the Treatment of Stress Urinary Incontinence in Women—A Pilot Study. Neuromodulation: Technology at the Neural Interface. 2013;16:590-594.
- 8. Allon EF. The role of neuromuscular electrical stimulation in the rehabilitation of the pelvic floor muscles. Br J Nurs. 2019;28:968-974.
- 9. Correia GN, Pereira VS, Hirakawa HS, et al. Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence:randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2014; 173:113-118.
- 10. Green RJ, Laycock J. Objective Methods for Evaluation of Interferential Therapy in the Treatment of Incontinence. Trans Biomed Eng. 1990; 37:615-623.
- 11. Maher RM, Hayes DM. How Do Pelvic Floor Muscle Contractions Elicited by 2 Different Delivery Methods of Neuromuscular Electrical Stimulation Compare With Volitional Contractions in Supine and Standing in Nulliparous Continent Women? J Womens Health Phys Therap. 2018;42:87-93.
- 12. O’Reilly B, O’Sullivan O, Siddiqui K, et al. Change in quality of life scores in incontinence patients following an intervention of external electrical stimulation as determined by the Kings Health Questionnaire. Continence Foundation of Ireland, Annual Study Day. 2016.
- 13. Kelleher CJ, Pleil AM, Reese PR, et al. How much is enough and who says so? The case of the King's Health Questionnaire and overactive bladder. BJOG. 2004;111:605-612.
- 14. Abdelbary AM, El-Dessoukey AA, Massoud AM, et al. Combined vaginal pelvic floor electrical stimulation (pfs) and local vaginal estrogen for treatment of overactive bladder (OAB) in perimenopausal females. Randomized controlled trial (RCT). Urol. 2015;86:482-486.
- 15. Kaya S, Akbayrak T, Gursen C, et al. Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J. 2015;26:285-293.
- 16. O'sullivan R, Karantanis E, Stevermuer T, et al. Definition of mild, moderate and severe incontinence on the 24‐hour pad test. BJOG. 2004;111:859-862.
- 17. Stach-Lempinen B, Kujansuu E, Laippala P, et al. Visual Analogue Scale, Urinary Incontinence Severity Score and 15 D’Psychometric Testing of Three Different Health-related Quality-of-life Instruments for Urinary Incontinent Women. Scand J Urol Nephrol. 2001;35:476-483.
- 18. Lagro-Janssen A, Debruyne F, Smits A, et al. The effects of treatment of urinary incontinence in general practice. Fam Pract. 1992;9:284-289.
- 19. Dmochowski R, Lynch CM, Efros M,et al. External Electrical Stimulation Compared With Intravaginal Electrical Stimulation for the Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Noninferiority Trial.2019;38:1834-1843.
- 20. Soeder S, Tunn R. Neuromuscular electrical stimulation (NMES) of the pelvic floor muscles using a non-invasive surface device in the treatment of stress UI (SUI); a pilot study. IUGA Poster Presentation Conference; 2013.
- 21. Huebner M, Riegel K, Hinninghofen H, et al. Pelvic floor muscle training for stress urinary incontinence: A randomized, controlled trial comparing different conservative therapies. Physiother Res Int. 2011;16:133-140.
- 22. Lose G, Jørgensen L, Thunedborg P. 24‐Hour Home Pad Weighing Test versus 1‐Hour Ward Test in The Assessment of Mild Stress Incontinence. Acta Obstet Gynecol Scand. 1989;68:211-215.
- 23. Akbayrak T, Yüksel I, Demirturk F. The short-term effects of physical therapy in different intensities of urodynamic stress incontinence. Gynecol Obstet Invest. 2005;59:43-48.
- 24. Delancey JOL. Structural aspects of urethrovesical function in the female. Neurourol Urodyn. 1988;7:509-519.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 7 Mayıs 2021 |
| Gönderilme Tarihi | 17 Ocak 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 8 Sayı: 1 |
