Effect of transvaginal stimulation in the treatment of detrusor instability. 1996

A N Elgamasy, and V Lewis, and M E Hassouna, and G M Ghoniem
Department of Urology at Tulane University School of Medicine, New Orleans, Louisiana, USA.

BACKGROUND Early research on implantable electrodes for transvaginal stimulation had high rates of complications and mechanical failures. Today's nonimplantable devices are safe for short-term or long-term use. This study evaluated an intermittent short-term transvaginal stimulation program for treatment of bladder overactivity. METHODS Fifteen women who ranged in age from 22 to 96 years and had bladder instability were enrolled into this noncontrolled, open, clinical evaluation program. Six to 10 biweekly office sessions were followed by use of a home unit twice daily for approximately 6 weeks. RESULTS Results were based on patients' voiding diaries. All 15 completed the study, and 73% were satisfied with the results. On pretrial urodynamic examination nine patients had sensory urgency, and six patients had involuntary contractions. All tolerated therapy without side effects. Two women had slight vaginal discomfort because of vaginal narrowing. Urinary frequency, urgency, and nocturia were significantly decreased. Seven women reported 75% or more improvement; four women reported 50% to 75% improvement. Three women required a second office treatment series. CONCLUSIONS The results of this study support findings of previous researchers, although the follow-up time frame of the study was short. Most of these patients (N = 11 of 15) wished to continue transvaginal stimulation. When three women discontinued home treatments, symptoms recurred in 1 to 3 months. The exact cause is unclear, but scar tissue as a result of previous pelvic operations may have contributed to the problem. The second course of treatment had positive results. Intermittent therapy in these cases is recommended. Transvaginal stimulation should be considered for treatment for urinary incontinence because the device is easily used and adjusted by the patient, patients may be very compliant, and results are satisfactory and at least similar to those attained with drug therapy.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D014549 Urinary Incontinence Involuntary loss of URINE, such as leaking of urine. It is a symptom of various underlying pathological processes. Major types of incontinence include URINARY URGE INCONTINENCE and URINARY STRESS INCONTINENCE. Incontinence, Urinary
D014563 Urodynamics The mechanical laws of fluid dynamics as they apply to urine transport. Urodynamic
D014621 Vagina The genital canal in the female, extending from the UTERUS to the VULVA. (Stedman, 25th ed) Vaginas

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