2018, Number 5
Response of the pelvic floor musculature to transcutaneous electrical stimulation of the pudendal nerve during biofeedback for urge incontinence
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ABSTRACTBackground: Urge incontinence is a highly prevalent condition and is reported at 60% in Mexico. It causes different degrees of incapacity in relation to daily life. Treatment includes behavioral therapy and neuromodulation.
Objective: To evaluate the response of the pelvic floor musculature during biofeedback assisted by transcutaneous electrical stimulation of the pudendal nerve in patients with urge incontinence.
Materials and Methods: A non-experimental, longitudinal, observational clinical study was conducted on patients with urge incontinence that received behavioral treatment with biofeedback assisted by transcutaneous electrical stimulation of the pudendal nerve. Patient age, progression, and bladder diary parameters were recorded. Perineometry was recorded in the resting state and in voluntary pelvic floor musculature using the Andromeda® urodynamic equipment with a transrectal transducer and transcutaneous electrical stimulation of the pudendal nerve was carried out using the Staodyn® EMS+2 neuromuscular stimulator. The data were analyzed utilizing the SPSS 10.1 program (95% CI and Student’s t test).
Results: Fourteen patients were included in the study and their mean age was 59.8 ± 11.80 years. During the first session, the mean perineometric value in the resting state was 1.21 ± 0.42 cmH20, in voluntary contraction it was 13.64 ± 7.09 cmH20, and during transcutaneous electrical stimulation of the pudendal nerve it was 46.42 ± 7.14 cmH20 (p‹0.05). No adverse effects were reported.
Conclusions: The intense contraction of the pelvic floor musculature (50 cmH2O) caused by transcutaneous electrical stimulation of the pudendal nerve during biofeedback signifies that said neuromodulation technique is effective, easy to use, and highly reproducible in patients with urge incontinence.
Milsom I, et al. Committee 1. Epidemiology of Urinary Incontinence (UI) and other Lower Urinary Tract Symptoms (LUTS), Pelvic Organ Prolapse (POP) and Anal Incontinence (AI). In: Abrams P, et al, editors. International Consultation on Incontinence, Tokyo, September 2016. 6th ed. London, UK; 2017:1-92.