Effects and indications of sacral surface therapeutic electrical stimulation in refractory urinary incontinence.

OBJECTIVE

To describe the effects and indications of sacral surface therapeutic electrical stimulation (SS-TES) for refractory urinary incontinence.

DESIGN

Evaluation before and after therapy.

SETTING

On clinical site and at nursing home.

SUBJECTS: Seven neurogenic bladder, five unstable bladder and six nocturia cases were investigated. Twelve were outpatients and six were residents.

INTERVENTIONS: 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.

MAIN OUTCOME MEASURES: 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.

CONCLUSION

SS-TES was effective in some patients with refractory urinary incontinence.