open access
The therapeutic effect of neuromuscular electrical stimulation by different pulse widths for overactive bladder in elderly women: a randomized controlled study
Affiliations- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, China
open access
Abstract
Objectives: There have been a number of controversies about which treatment of neuromuscular electrical stimulation (NMES) is more beneficial for overactive bladder (OAB). An attempt to investigate the therapeutic effect of NMES with different pulse widths for OAB in elderly women has been made in this study.
Material and methods: The postmenopausal elderly women without pelvic organ prolapse (POP) who received transvaginal NMES in Beijing Hospital from November 2020 to December 2020 were randomly divided into two groups (Group A and Group B). Patients from Group A accepted the treatment with NMES by pulse width of 300 μs and patients from Group B accepted the treatment with NMES by pulse width of 200 μs. Myoelectric potential of Type I and Type II muscle fibers at pelvic floor and overactive bladder symptom score (OABSS) were valued.
Results: There were 46 patients eligible for the study and randomly divided into Group A and Group B, 23 patients for
each group. OABSS were significantly reduced in both groups after the treatment of NEMS. And OABSS in Group A (after treated by pulse width of 300 μs) were significantly decreased greater than those in Group B (after treated with pulse width of 200 μs). Both Group A and Group B had no significant difference in the mean myoelectric potential at pre-resting state when compared before and after the treatment of NEMS. Myoelectric potential of Type I muscle fiber and the maximum myoelectric potential of Type II muscle fibers were significantly increased after the treatment of NEMS than before the treatment in the two groups, respectively. And myoelectric potential of Type I muscle fiber and the maximum myoelectric potential of Type II muscle fibers in group A (after treated with pulse width of 300 μs) were increased significantly much higher than those in Group B (after treated with pulse width of 200 μs).
Conclusions: Comparing the indicators before and after the treatments of NMES, our study has preliminarily confirmed that NMES has its advantages in treating with OAB. And NMES by pulse width of 300 μs were more effective in improving pelvic floor muscle strength than NMES by pulse width of 200 μs.
Abstract
Objectives: There have been a number of controversies about which treatment of neuromuscular electrical stimulation (NMES) is more beneficial for overactive bladder (OAB). An attempt to investigate the therapeutic effect of NMES with different pulse widths for OAB in elderly women has been made in this study.
Material and methods: The postmenopausal elderly women without pelvic organ prolapse (POP) who received transvaginal NMES in Beijing Hospital from November 2020 to December 2020 were randomly divided into two groups (Group A and Group B). Patients from Group A accepted the treatment with NMES by pulse width of 300 μs and patients from Group B accepted the treatment with NMES by pulse width of 200 μs. Myoelectric potential of Type I and Type II muscle fibers at pelvic floor and overactive bladder symptom score (OABSS) were valued.
Results: There were 46 patients eligible for the study and randomly divided into Group A and Group B, 23 patients for
each group. OABSS were significantly reduced in both groups after the treatment of NEMS. And OABSS in Group A (after treated by pulse width of 300 μs) were significantly decreased greater than those in Group B (after treated with pulse width of 200 μs). Both Group A and Group B had no significant difference in the mean myoelectric potential at pre-resting state when compared before and after the treatment of NEMS. Myoelectric potential of Type I muscle fiber and the maximum myoelectric potential of Type II muscle fibers were significantly increased after the treatment of NEMS than before the treatment in the two groups, respectively. And myoelectric potential of Type I muscle fiber and the maximum myoelectric potential of Type II muscle fibers in group A (after treated with pulse width of 300 μs) were increased significantly much higher than those in Group B (after treated with pulse width of 200 μs).
Conclusions: Comparing the indicators before and after the treatments of NMES, our study has preliminarily confirmed that NMES has its advantages in treating with OAB. And NMES by pulse width of 300 μs were more effective in improving pelvic floor muscle strength than NMES by pulse width of 200 μs.
Keywords
neuromuscular electrical stimulation; overactive bladder; pelvic floor muscles; overactive bladder symptom score; myoelectric potential; pulse width
About this articleTitle
The therapeutic effect of neuromuscular electrical stimulation by different pulse widths for overactive bladder in elderly women: a randomized controlled study
Journal
Issue
Article type
Research paper
Pages
620-628
Published online
2021-10-05
Page views
4260
Article views/downloads
647
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(8):620-628.
Keywords
neuromuscular electrical stimulation
overactive bladder
pelvic floor muscles
overactive bladder symptom score
myoelectric potential
pulse width
Authors
Aiming Lv
Tianzi Gai
Qing Feng
Min Li
Wenhui Deng
Qiubo lv
References (35)- Haylen BT, de Ridder D, Freeman RM, et al. International Urogynecological Association, International Continence Society. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29(1): 4–20.
- Wang Y, Xu K, Hu H, et al. Prevalence, risk factors, and impact on health related quality of life of overactive bladder in China. Neurourol Urodyn. 2011; 30(8): 1448–1455.
- Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003; 20(6): 327–336.
- Robinson D, Cardozo L, Milsom I, et al. Oestrogens and overactive bladder. Neurourol Urodyn. 2014; 33(7): 1086–1091.
- Yi J, Tenfelde S, Tell D, et al. Triathlete Risk of Pelvic Floor Disorders, Pelvic Girdle Pain, and Female Athlete Triad. Female Pelvic Med Reconstr Surg. 2016; 22(5): 373–376.
- Khan AA, Eilber KS, Clemens JQ, et al. Trends in management of pelvic organ prolapse among female Medicare beneficiaries. Am J Obstet Gynecol. 2015; 212(4): 463.e1–463.e8.
- Brueseke TJ, Wilkins MF, Willis-Gray MG, et al. Lifetime risk of surgery for stress urinary incontinence or pelvic organ prolapse. Minerva Ginecol. 2017; 69(2): 171–177.
- Malde S, Kelly S, Saad S, et al. Case-finding tools for the diagnosis of OAB in women: A narrative review. Neurourol Urodyn. 2020; 39(1): 13–24.
- Wallace SA, Roe B, Williams K, et al. Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev. 2004(1): CD001308.
- Wein A. Commentary RE: The Standardization of Terminology in Lower Urinary Tract Function: Report From the Standardization Subcommittee of the International Continence Society. Urology. 2020; 145: 310–311.
- Hay-Smith J, Herbison P, Ellis G, et al. Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev. 2005(3): CD005429.
- D'Souza AO, Smith MJ, Miller LA, et al. Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan. J Manag Care Pharm. 2008; 14(3): 291–301.
- Lúcio A, Dʼancona CA, Perissinotto MC, et al. Pelvic Floor Muscle Training With and Without Electrical Stimulation in the Treatment of Lower Urinary Tract Symptoms in Women With Multiple Sclerosis. J Wound Ostomy Continence Nurs. 2016; 43(4): 414–419.
- Jundt K, Peschers U, Kentenich H. The investigation and treatment of female pelvic floor dysfunction. Dtsch Arztebl Int. 2015; 112(33-34): 564–574.
- Candy B, Jones L, Vickerstaff V, et al. Interventions for sexual dysfunction following treatments for cancer in women. Cochrane Database Syst Rev. 2016; 2: CD005540.
- Silva VR, Riccetto CL, Martinho NM, et al. Training through gametherapy promotes coactivation of the pelvic floor and abdominal muscles in young women, nulliparous and continents. Int Braz J Urol. 2016; 42(4): 779–786.
- Homma Y, Yoshida M, Seki N, et al. Symptom assessment tool for overactive bladder syndrome--overactive bladder symptom score. Urology. 2006; 68(2): 318–323.
- Robinson AJ, Snyder-Mackler L. Clinical electrophysiology: electrotherapy and electrophysiologic testing, third edition. Lippincott Williams & Wilkins, Philadelphia 1997.
- Chen LC, Kuo HC, Chen LC, et al. Pathophysiology of refractory overactive bladder. Low Urin Tract Symptoms. 2019; 11(4): 177–181.
- Yu M, Uy J, Jiang X, et al. An excitatory reflex from the superficial peroneal nerve to the bladder in cats. Am J Physiol Renal Physiol. 2017; 313(5): F1161–F1168.
- Dumitru D, King JC, Zwarts MJ. Determinants of motor unit action potential duration. Clin Neurophysiol. 1999; 110(11): 1876–1882.
- Shen J, Nie X, Huang SY, et al. Neuromuscular electrical stimulation improves muscle atrophy induced by chronic hypoxia-hypercapnia through the MicroRNA-486/PTEN/FoxO1 pathway. Biochem Biophys Res Commun. 2019; 509(4): 1021–1027.
- Qiu S, Feng J, Xu J, et al. Sonomyography Analysis on Thickness of Skeletal Muscle During Dynamic Contraction Induced by Neuromuscular Electrical Stimulation: A Pilot Study. IEEE Trans Neural Syst Rehabil Eng. 2017; 25(1): 59–67.
- Bochkezanian V, Newton RU, Trajano GS, et al. Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on muscle force production in people with spinal cord injury (SCI). BMC Neurol. 2018; 18(1): 17.
- Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci. 2003; 26(1): 17–22.
- Eriksen BC. Electrostimulation of the pelvic floor in female urinary incontinence. Acta Obstet Gynecol Scand. 1990; 69(4): 359–360.
- Okui N, Okui M, Horie S. Improvements in overactive bladder syndrome after polypropylene mesh surgery for cystocele. Aust N Z J Obstet Gynaecol. 2009; 49(2): 226–231.
- Chou ECL, Hung MJ, Yen TW, et al. The translation and validation of Chinese overactive bladder symptom score for assessing overactive bladder syndrome and response to solifenacin treatment. J Formos Med Assoc. 2014; 113(8): 506–512.
- Jiang F, Zhu L, Xu T, et al. Efficacy and safety of solifenacin succinate tablets versus solifenacin succinate tablets with local estrogen for the treatment of overactive bladder in postmenopausal women--a multicenter, randomized, open-label, controlled comparison study. Menopause. 2016; 23(4): 451–457.
- Lightner DJ, Gomelsky A, Souter L, et al. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment 2019. J Urol. 2019; 202(3): 558–563.
- Choi H, Bae JH, Oh CY, et al. Clinical Efficacy of Solifenacin in the Management of Diabetes Mellitus-Associated Versus Idiopathic Overactive Bladder Symptoms: A Multicenter Prospective Study. Int Neurourol J. 2018; 22(1): 51–57.
- Noblett K, Siegel S, Mangel J, et al. Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder. Neurourol Urodyn. 2016; 35(2): 246–251.
- CALDWELL KP. The electrical control of sphincter incompetence. Lancet. 1963; 2(7300): 174–175.
- Messelink EJ. The overactive bladder and the role of the pelvic floor muscles. BJU Int. 1999; 83 Suppl 2: 31–35.
- Amaro JL, Gameiro MO, Kawano PR, et al. Intravaginal electrical stimulation: a randomized, double-blind study on the treatment of mixed urinary incontinence. Acta Obstet Gynecol Scand. 2006; 85(5): 619–622.
