Effects of functional electrical stimulation on the urethral closing muscles

Abstract

The importance of the selection of patients with urinary incontinence suitable for treatment with functional electrical stimulation (f.e.s.) was tested. 40 patients with urinary incontinence of different kinds (mostly stress incontinence) were selected on the basis of urological, neurophysiological and urodynamic examinations. The positive response to optimal f.e.s. was a criterion for urodynamic selection. Mechanical properties of the unstimulated and electrically stimulated urethral wall tissue in the functional part of the urethra were studied. The differences between the acute effects of different types of stimulation, namely monophasic and biphasic f.e.s. with vaginal or different types of anal plugs and mechanical stimulation produced by these plugs, were stated. An attempt was made to quantify the success of treatment with f.e.s. Besides the routine urological, neurophysiological and urodynamic methods, the investigative methods of measuring the urethral pressure profile (u.p.p.) and measuring the pressure at one point of the urethra, by means of Mikro-Tip pressure transducers, were used in our study. Errors due to the dimensions of the measuring device causing a nonphysiological dilatation of the urethra were considered in the method of measuring the u.p.p.