Abstract
Objective The purpose of this study is to assess the effectiveness of pelvic floor muscle training and extracorporeal magnetic innervation in treatment of urinary incontinence in women with stress urinary incontinence. Methods The randomized controlled trial enrolled 128 women with stress urinary incontinence who were randomly allocated to either one out of two experimental groups (EG1 or EG2) or the control group (CG). Subjects in the experimental group 1 (EG1) received 12 sessions of pelvic floor muscle training, whereas subjects in the experimental group 2 (EG2) received 12 sessions of extracorporeal magnetic innervation. Subjects in the control group (CG) did not receive any therapeutic intervention. The following instruments were used to measure results in all study groups at the initial and final assessments: Revised Urinary Incontinence Scale (RUIS), Beck Depression Inventory (BDI-II), General Self-Efficacy Scale (GSES), and King's Health Questionnaire (KHQ). Results In both experimental groups, a statistically significant decline in depressive symptoms (BDI-II) and an improvement in urinary incontinence severity (RUIS) and quality of life (KHQ) were found in the following domains: “social limitations,” “emotions,” “severity measures,” and “symptom severity scale.” Moreover, self-efficacy beliefs (GSES) improved in the experimental group that received ExMI (EG2). No statistically significant differences were found between all measured variables in the control group. Comparative analysis of the three study groups showed statistically significant differences at the final assessment in the quality of life in the following domains: “physical limitations,” “social limitations,” “personal relationships,” and “emotions.” Conclusion. Pelvic floor muscle training and extracorporeal magnetic innervation proved to be effective treatment methods for stress urinary incontinence in women. The authors observed an improvement in both the physical and psychosocial aspects.
Highlights
Introduction e World HealthOrganization (WHO) and the International Continence Society (ICS) define urinary incontinence (UI) as an involuntary leakage of urine through the urethra and consider it a health, social, and hygienic concern [1].e Standardisation Steering Committee (SSC) recognizes three main types of UI: stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI)
In the following series of studies, the authors assessed the effectiveness of pelvic floor muscle training (PFMT) and extracorporeal magnetic innervation (ExMI). e European Association of Urology (EAU) recommends the use of pelvic floor muscle training as a basic nonsurgical treatment for UI [3], whereas extracorporeal magnetic innervation (ExMI) is a rather new physiotherapy method used in the treatment of urinary incontinence
During an ExMI treatment session, patients are seated in a special chair with a magnetic field generator in the seat. e magnetic field emitted by the generator penetrates pelvis minor organs and acts on motor fibers of pudendal and visceral nerves
Summary
E authors stratified randomization by allocating participants to one of the three study groups. Study inclusion criteria were as follows: diagnosed SUI, and no contradictions to the PFMT or ExMI treatment. Contradictions to PFMT were as follows: active malignancy, recent surgeries, recent pelvic fractures, fever, acute inflammations, uterine tumors and myomas, urinary or genital tract infections, grade 3 or 4 hemorrhoids, stage 3 uterine prolapse (downward displacement of the uterus into the vagina) [8]. Contradictions to ExMI were as follows: pregnancy, recent pelvic fractures, fever, acute inflammations, active malignancy, uterine tumors and myomas, stage 3 uterine prolapse, hemorrhoids, urinary or genital tract infections, suspected urethral and/or vesical fistula, severe urethral sphincter weakness and/or defect, deep vein thrombosis, acute infections, cardiac arrhythmia, cardiac pacemaker, and neurological diseases [6]. Study exclusion criteria were as follows: presence of contraindications to the PFMT or ExMI treatment, diagnosed MUI or UUI, and recent therapeutic interventions in UI 3 months prior to the study (PFMT, ExMI, electrostimulation, or biofeedback)
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