Abstract
ABSTRACTPurpose:To evaluate the efficacy of intravaginal electrical stimulation (IVES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB).Materials and Methods:Sixty-two women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n:31), and Group 2 received BT+IVES (n:31). IVES was performed for twenty minutes three days a week over a course of eight weeks for a total of 24 sessions. Patients were evaluated in terms of incontinence severity (24-hour pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes and number of pads), symptom severity (OAB-V8), incontinence-related QoL (IIQ-7), treatment success (positive response rate), cure/improvement rate and treatment satisfaction (Likert scale).Results:A statistically significant improvement was found in all parameters for all groups at the end of the treatment compared to the baseline values except pelvic floor muscles strength in Group 1 (p <0.05). At the end of treatment, incontinence severity, frequency of voiding, nocturia, incontinence episodes, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p <0.05). Treatment satisfaction, cure/improvement, and positive response rates were significantly higher in group 2 compared to Group 1 (p <0.05).Conclusion:We conclude that BT+IVES were more effective than BT alone on both incontinence-related QoL and clinical parameters in women with idiopathic OAB.
Highlights
Overactive bladder (OAB) is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence (UUI) according to the International Continence Society [1]
Two groups were comparable for the severity of incontinence, pelvic floor muscle (PFM) strength, frequency of voiding, incontinence episodes, nocturia, number of pads, symptom severity, and quality of life (QoL) parameters at baseline (p >0.05) (Table-2)
No serious adverse events were reported in both groups except temporary discomfort due to vaginal irritation in four women in Group 2. In this prospective, randomized controlled trial, we have investigated the effectiveness of Intravaginal electrical stimulation (ES) (IVES) added to bladder training (BT) on QoL and clinical parameters associated with incontinence in women with idiopathic OAB
Summary
Overactive bladder (OAB) is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence (UUI) according to the International Continence Society [1]. Many drugs such as oral anti-muscarinic agents and oral ß3 adrenoreceptor agonist (mirabegron) and first-line conservative therapeutic options are commonly used for UUI and OAB, including electrical stimulation (ES), pelvic floor muscle (PFM) training and behavioral therapies such as lifestyle changes and bladder training (BT) [1,2,3,4,5,6]. There is controversy in scientific literature regarding its effectiveness as monotherapy [7]
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