Low-Frequency Stimulation Provides Significant Added Benefit for Postpartum Urinary Incontinence: A Retrospective Cohort Study.

AIMS: To evaluate the clinical efficacy of low-frequency electrical stimulation (LES) in treating UI among postpartum women.

METHODS

Postpartum women diagnosed with UI who received treatment at two tertiary hospitals between 1st January and 30th June 2020 were included. Patients received one of two regiments: (1) 10 sessions of functional electrical stimulation (FES) at 30-40 Hz combined with biofeedback (FES-BF group); (2) 4 sessions of LES (2-10 Hz) followed by 6 sessions of FES combined with biofeedback (LES-BF group). The primary outcome was the improvement in urine leakage frequency according to a 7-day bladder diary. The secondary outcomes included cure, severity of UI, quality of life, pelvic floor muscle strength, surface electromyography levels, pain intensity, and pelvic organ prolapse quantification. Multivariate logistic regression and double robust analysis were conducted.

RESULTS

A total of 217 women were involved (LES-BF vs. FES-BF: 102 vs. 115). The LES-BF group demonstrated a significantly higher cure rate in urinary leakage frequency compared to the FES-BF group (36 [35.3%] vs. 25 [21.7%], χ² = 4.915, p = 0.027, OR = 2.85 [95% CI: 1.32 to 6.17]), which confirmed by doubly robust analysis (OR = 3.46, 95% CI: 1.66 to 7.19). We also found superior pelvic muscles strength recovery in the LES-BF group compared to FES-BF group (p < 0.05).

CONCLUSIONS

The combination of LES and FES was associated with a significant short-term cure in postpartum UI over FES alone. This protocol could be a candidate treatment option for UI, justifying further validation in randomized controlled trials.

CLINICAL TRIAL REGISTRATION: This study was registered at the Chinese Clinical Trial Registry (ChiCTR19000 21717).