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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 09

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Ginecol Obstet Mex 2021; 89 (09)

Vaginal electrostimulation and posterior tibial nerve stimulation in voiding dysfunction treatment

López-Talavera VJ, Rodríguez-Colorado ES, Gorbea-Chávez V, Ramírez-Isarraraz C, Granados-Martínez V

Language: Spanish
References: 18
Page: 678-687
PDF size: 215.68 Kb.


ABSTRACT

Objective: To analyze the effect of electrotherapy on symptoms in patients with bladder emptying disorder.
Materials and Methods: Cohort, retrospective, case series study, performed at the Gynecologic Urology Clinic of the Instituto Nacional de Perinatología Isidro Espinosa de los Reyes from January 2017 to December 2019. Inclusion criteria: patients with bladder emptying disorders treated with vaginal or surface electrotherapy for at least 8 sessions. Exclusion criteria: patients with incomplete data in the record. Response was evaluated by symptoms, visual analog scale, percentage of improvement and pre- and post-treatment urodynamics. Statistical analysis was processed with SPSS version 26. Statistically significant values were considered to be p ‹ 0.05.
Results: Two groups were analyzed: group 1 (n = 25) that received intracavitary stimulation with vaginal electrode and group 2 (n = 24) treated with stimulation of the posterior tibial nerve with surface electrode, with frequencies of 10 Hz for 20 minutes every week for 12 weeks. At the end of this period, a decrease in the sensation of incomplete voiding and double urination was found in both groups. Regarding urinary urgency and intermittent urination, improvement was only found with posterior tibial nerve stimulation. Intracavitary stimulation, with vaginal electrode, produced a decrease in detrusor pressure at peak flow (PdetQmax) of 4.67 cmH2O (p = 0.004), disinergic EMG activity of 62.5% (p = 0.001) and residual urine of 66.63 mL (p = 0.016), with an increase in peak free flow (Qmax) of 5 mL/s (p = 0.001). Posterior tibial nerve stimulation with a similar pattern that was only significant in free Qmax (from 10.72 to 14.92 with p = 0.001).
Conclusion: Electrotherapy, in its different modalities, reduces lower urinary tract symptoms and is a safe alternative in patients in whom behavioral and pharmacological therapy has been of little benefit. Intracavitary stimulation seems beneficial in patients with bladder emptying disorder, since a significantly greater response was found in clinical and urodynamic parameters versus posterior tibial nerve stimulation.


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