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Yao H, Zhang X, Sun F, Tang G, Wu J, Zhou Z. The efficacy of intravaginal electrical stimulation (IVES) in treating female with urinary incontinence symptom from meta-analysis of nine randomized controlled trials. Front Neurol 2022; 13:933679. [PMID: 36176556 PMCID: PMC9514856 DOI: 10.3389/fneur.2022.933679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundUrinary incontinence (UI) is a common disease in the middle-aged and elderly women, and physical therapy has gradually become the mainstream treatment of UI. We conducted a meta-analysis to evaluate the efficacy of intravaginal electrical stimulation (IVES) in the treatment of UI.MethodsFrom January 2006 to December 2021, we finally selected nine randomized controlled trials (RCTs) including 657 participants from PubMed, EMBASE, and Cochrane databases to evaluate the efficacy of IVES in the treatment of female UI. Continuous data were represented by mean difference and 95% CI, while dichotomous data were represented by odds ratio and 95% CI. All the data were analyzed by the Review Manager Version 5.4.ResultsCompared with the control group, there were significant improvements in urine pad test (P = 0.01), urinary incontinence frequency (P = 0.04), some indicators in the incontinence quality of life questionnaire and King's health questionnaires, and subjective feeling of cure (P = 0.009) in the IVES group. However, in other indicators reflecting UI, there was no significant difference between the IVES group and the control group. In addition, subgroup analysis showed that IVES and IVES combined with training could significantly reduce the weight of the urine pad, which reflected the improvement of urine leakage.ConclusionThis meta-analysis proved that IVES can partially improve the symptoms of female patients with UI compared with the control group. However, it still needs to be further evaluated through more high-quality research in the future.
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Affiliation(s)
- Huibao Yao
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Xiaofei Zhang
- Department of Neurology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Fengze Sun
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Gonglin Tang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
- Jitao Wu
| | - Zhongbao Zhou
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Zhongbao Zhou
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Bae S, Lee KW, Jeong HC, Park BH, Bae WJ, Lee YS, Han CH, Kang SH, Kim SW. Effects of low-frequency intravaginal electrical stimulation on female urinary incontinence, quality of life, and urinary symptoms: A pilot study. Low Urin Tract Symptoms 2019; 12:25-32. [PMID: 31595693 DOI: 10.1111/luts.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/17/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
This study investigated the effects of a low-frequency home-based incontinence therapy device on quality of life (QoL) and urinary symptoms in women with urinary incontinence. From May 2017 to February 2018, 34 patients, aged ≥ 20 years, with involuntary urine leakage >2 times/week, were recruited to this study. Patients with severe pelvic organ prolapse, pregnancy, virgin status, and psychological problems were excluded. The incontinence home-care device treatments were administered in 12-minute sessions, twice daily for 8 weeks. Simultaneously, hyperthermic conditions of 35°C to 40°C and microvibrations were administered. All patients completed urinary incontinence questionnaires (King's Health Questionnaire [KHQ], Bristol Female Lower Urinary Tract Symptoms [BFLUTS] questionnaire, and the Overactive Bladder Symptom Score [OABSS]) before treatment, as well as 4 and 8 weeks into treatment. Changes in the questionnaire responses over time were compared. Two participants dropped out of the study and there was one screening failure, leaving 31 patients for analysis. After 4 weeks treatment, there were significant improvements in symptoms, such as role limitation, physical limitation, social limitation, personal relationship, emotion, sleep/energy, and severity measures. After 8 weeks treatment, almost all parameters on the KHQ revealed symptomatic improvement. On the BFLUTS, voiding times during activity, nocturia, urgency, urge incontinence, incontinence frequency, stress incontinence, volume leakage, strain to start, intermittency, reduced stream, acute retention, incomplete emptying, and stopping flow showed significant improvements. On the OABSS, almost all storage symptoms improved. Low-frequency electrical stimulation devices were effective at improving urinary incontinence, which became evident as the duration of treatment increased. Improvement of urgency and frequency was more evident after treatment.
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Affiliation(s)
- Sangrak Bae
- Department of Urology, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyu Won Lee
- Department of Urology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Cheol Jeong
- Department of Urology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Bong Hee Park
- Department of Urology, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woong Jin Bae
- Department of Urology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong Seok Lee
- Department of Urology, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Hee Han
- Department of Urology, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Hak Kang
- Department of Urology, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Chen LC, Kuo HC. Pathophysiology of refractory overactive bladder. Low Urin Tract Symptoms 2019; 11:177-181. [PMID: 30900373 DOI: 10.1111/luts.12262] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/26/2019] [Accepted: 02/27/2019] [Indexed: 12/15/2022]
Abstract
Overactive bladder (OAB) is a common condition. The International Continence Society defines OAB as a symptom complex characterized by urgency with or without urge incontinence, usually with frequency and nocturia. The first-line treatment for OAB includes behavioral therapy, such as caffeine reduction, fluid intake modification, weight reduction, bladder training, and pelvic floor muscle training, as well as treatment with antimuscarinic or β3 -adrenoceptor agonist medications. However, less than half of all cases achieve satisfactory outcomes following first-line treatment. Second-line therapy considered if satisfactory responses are not achieved after 8 to 12 weeks treatment with first-line therapy include intradetrusor botulinum toxin injection, neuromodulation, and surgical treatment. Patients with refractory OAB may have more severe symptoms or underlying pathophysiologies that were not resolved by the initial medication. The pathophysiologies of refractory OAB include occult neurogenic bladder, undetected bladder outlet obstruction, urethral-related OAB, urothelial dysfunction with aging, chronic bladder ischemia, chronic bladder inflammation, central sensitization, and autonomic dysfunction. This article discusses the possible pathophysiologies of refractory OAB.
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Affiliation(s)
- Li-Chen Chen
- Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Efficacy and Safety of Incontinence Surgery According to the Surgeon's Specialty and Performance of a Preoperative Urodynamic Study. Int Neurourol J 2018; 22:305-312. [PMID: 30599502 PMCID: PMC6312978 DOI: 10.5213/inj.1836104.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/21/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose The aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon’s specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset. Methods We enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon’s specialty and whether a preoperative UDS was performed. Results The hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103–1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon’s specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122–1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed. Conclusions This population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon’s specialty and that the reoperation rate according to the surgeon’s specialty varied based on whether a preoperative UDS was performed.
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Lee BJ, Kim J, Kim KH. Association of gastric and duodenal ulcers with anthropometry and nutrients: Korean National Health and Nutrition Examination Survey (KNHANES II-IV) 2001-2009. PLoS One 2018; 13:e0207373. [PMID: 30440018 PMCID: PMC6237383 DOI: 10.1371/journal.pone.0207373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/30/2018] [Indexed: 12/05/2022] Open
Abstract
Objectives The objective of this study was to examine the association of peptic ulcer disease (PUD), including gastric ulcer and duodenal ulcer, with obesity-related indices, nutrients, and blood parameters in Korean adults. Methods Data were obtained from the Second-Fourth Korean National Health and Nutrition Examination Survey (KNHANES II-IV). Binary logistic regression was carried out to analyze the association between PUD and all variables in the crude analysis; in a subsequent analysis, adjustments were made for age, region, house type, number of snacks per day, and number of household members. Results PUD exhibited the highest association with age in both men and women among all variables used in this study. In men, only body mass index was associated with PUD in both the crude and adjusted analyses. PUD was associated with weight, height, and fat in the crude analysis, but these associations disappeared after adjustment for confounders. Vitamin B2, hemoglobin, and glucose were related to PUD, but these associations became nonsignificant in the adjusted analysis. Water, vitamin C, and potassium were not associated with PUD in the crude analysis but were associated with PUD after adjustment for confounders. In women, systolic blood pressure and height were associated with PUD. PUD was also related to waist circumference, the waist-to-height ratio, fat, and cholesterol, but these associations became nonsignificant after adjustment for confounders. Vitamin C, protein, niacin, sodium, energy, vitamin B2, vitamin B1, and aspartate aminotransferases were associated with PUD in only the crude analysis. PUD was not associated with diastolic blood pressure, water, vitamin A, or glucose, but these factors were associated with the disease in the adjusted analysis. Conclusion Older age was a risk factor for PUD in Korean adults, and the association of PUD with most nutrients and anthropometric indices may differ according to gender.
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Affiliation(s)
- Bum Ju Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- * E-mail:
| | - Jihye Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Keun Ho Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Shen SX, Liu Y. A retrospective study of neuromuscular electrical stimulation for treating women with post-stroke incontinence. Medicine (Baltimore) 2018; 97:e11264. [PMID: 29952999 PMCID: PMC6039598 DOI: 10.1097/md.0000000000011264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022] Open
Abstract
This retrospective study evaluated the effect of using neuromuscular electrical stimulation (NMES) for the treatment of post-stroke urinary incontinence (PSUI) among female population in China.A total of 163 eligible patients with PSUI were included in this study. Of these, 103 patients were assigned to a treatment group, and 60 subjects were assigned to a control group. All patients in both groups received bladder training. In addition, patients in the treatment group also received NMES. All patients were treated for a total of 8 weeks. The outcome measurements included the amount of urine leakage, urinary symptoms and quality of life. The urinary symptoms were measured by the Bristol Female Urinary Symptoms Questionnaire (BFUSQ) score, and the quality of life was assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score. In addition, adverse events were also documented in this study.After 4-week treatment, patients who received NMES did not exert better outcomes in the amount of urine leakage, urinary symptoms, measured by BFUSQ scale, and the quality of life, assessed by ICIQ-SF scale. However, after 8-week treatment, patients in the treatment group showed greater effect in reducing the amount of urine leakage (P < .01), enhancing urinary symptoms, as measured by BFUSQ scale (P < .01), and improving the quality of life, as assessed by ICIQ-SF scale (P < .01), compared with patients in the control group. In addition, no adverse event was recorded during the period of 8-week treatment in this study.The results of this study indicated that NMES may benefit for patients with PSUI after 8-week treatment. Future studies should focus on warranting the results of this study.
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