TY - JOUR T1 - EFFICACY OF EXTRACORPOREAL ELECTROMAGNETIC STIMULATION FOR THE TREATMENT OF URINARY INCONTINENCE AND THE PREDICTIVE FACTORS FOR SATISFACTION TT - EKSTRAKORPOREAL ELEKTROMANYETİK STİMÜLASYONUN ÜRİNER İNKONTİNANS TEDAVİSİNDE ETKİNLİĞİ VE BAŞARIYI ETKİLEYEN FAKTÖRLERİN ANALİZİ AU - Güngör Uğurlucan, Funda AU - Yaşa, Cenk AU - Çapan, Nalan AU - Taş, İnci Sema AU - Ertürk, Emircan AU - Yalçın, Önay PY - 2024 DA - March Y2 - 2024 DO - 10.26650/IUITFD.1283129 JF - Journal of Istanbul Faculty of Medicine JO - İst Tıp Fak Derg PB - Istanbul University WT - DergiPark SN - 1305-6441 SP - 139 EP - 144 VL - 87 IS - 2 LA - en AB - Objective: Extracorporeal electromagnetic stimulation (ExMS) has been used widely to treat Urinary Incontinance (UI). We aim to analyze the subjective and objective outcomes of ExMS treatment and evaluate factors that could predict satisfaction.Material and Method: Patients who underwent ExMS treatment for UI were evaluated. ExMS was performed twice weekly with 20-minute sessions for six-eight weeks. Subjective satisfaction and objective improvement were evaluated before and three months after treatment with a bladder diary, pad test, and pelvic floor muscle strength assessment. King’s Health Questionnaire was used to evaluate quality of life.Result: Eighty-one patients were included. The mean age was 50.4±9.7 (30-76). Fourty four (54.3%) patients suffered from mixed UI, and 19 (23.5%) and 18 (22.2%) suffered from stress UI and urge UI, respectively. Six patients were cured, 64 (79.1%) were better than before, and the rest noticed no change. After treatment, there were significant improvements in bladder diary, pelvic floor muscle strength, pad test, and King’s Health Questionnaire. There was a significant correlation between the type of UI and satisfaction after treatment; women suffering from stress UI were less satisfied when compared to urge or mixed UI. No correlations were found between treatment satisfaction and age, pretreatment pelvic floor muscle strength, 1-hour pad test, or mean number of leakage and urgency episodes. No complications developed.Conclusion: ExMS is an effective treatment for UI with almost 80% subjective satisfaction. Quality of life, pad test, bladder diary, and pelvic floor muscle strength were improved significantly. The UI type (urge or mixed UI) was a significant predictive factor for treatment satisfaction. KW - Electromagnetic stimulation KW - mixed urinary incontinence KW - overactive bladder syndrome KW - quality of life KW - stress urinary incontinence KW - urinary incontinence N2 - Amaç: Elektromanyetik dalgalarla tedavi (ExMS) üriner inkontinansın tedavisinde sıklıkla kullanılmaktadır. Bu çalışmada, Üriner inkontinansın (İÜ) şikayetleri olan hastalarda EXMS tedavisinin etkinliğinin değerlendirilmesi ve tedavi memnuniyetini etkileyen faktörlerin analiz edilmesi amaçlanmıştır.Gereç ve Yöntem: Üriner inkontinans nedeniyle ExMS tedavisi uygulanan hastalar retrospektif olarak değerlendirilmiştir. ExMS, manyetik stimülasyon sandalyesi kullanılarak, haftada üç seans ve her seans 20 dakika olmak üzere altı-sekiz hafta boyunca uygulanmıştır. Subjektif memnuniyet, tedavi öncesi ve sonrasında ürojinekolojik semptomlar, bir saatlik ped testi, dört günlük üriner günlük, pelvik taban kas gücü ve King Sağlık Anketi değerlendirilmiştir.Bulgular: Seksen bir hasta çalışmaya dahil edilmiştir. Ortalama yaş 50,4±9,7’dir (30-76). Kırkdört (%54,3) hasta mikst Üİ, 19 hasta (%23,5) stres Üİ ve 18 hasta (%22,2) acil Üİ tanısı almıştır. ExMS tedavisinden memnuniyet değerlendirildiğinde, altı hasta tamamen iyileştiklerini, 64 hasta (%79,1) daha iyi olduklarını, geri kalan hastalar değişiklik olmadığını belirtmiştir. Tedavi sonrası üriner günlük, pelvik taban kas gücü, bir saatlik ped testi ve King Sağlık Anketi sonuçlarında anlamlı düzelme görülmüştür. Üriner inkontinans tipi ile memnuniyet arasında anlamlı ilişki bulunmuştur. Stres Üİ şikayeti olan kadınlarda memnuniyet urge veya mikst Üİ olanlara göre daha düşük bulunmuştur. Bunun dışında yaş, ped testi, pelvik taban kas gücü ve ortalama kaçak ve aciliyet sayısı ile memnuniyet arasında anlamlı ilişki bulunamamıştır. Tedavi esnasında veya sonrasında herhangi bir komplikasyon gelişmemiştir.Sonuç: ExMS, Üİ şikayeti olan kadınlarda etkin bir tedavidir. Subjektif tatmin oranları %80’e varmaktadır. Objektif olarak ped testi, pelvik taban kas gücü, üriner günlük ve hayat kalitesinde anlamlı düzelmeye neden olmaktadır. Üriner inkontinans tipi (urge veya mikst Üİ) tedavi memnuniyeti etkileyen bir faktördür. CR - Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardization of terminology of lower urinary tract function: report from the Standardization Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21(2):167. [CrossRef] google scholar CR - Thüroff JW, Abrams P, Andersson KE, Artibani W, Chapple CR, Drake MJ, et al. EAU Guidelines on Urinary Incontinence. Eur Urol 2011;59(3):387-400. [CrossRef] google scholar CR - Quek P. A critical review on magnetic stimulation: what is its role in the management of pelvic floor disorders? Curr Opin Urol 2005;15:231-5. [CrossRef] google scholar CR - Goldberg RP, Sand PK. Electromagnetic pelvic floor stimulation: applications for the gynecologist. Obstet Gynecol Surv 2000;55(11):715-20. [CrossRef] google scholar CR - Goldberg RP, Sand PK. Extracorporeal electromagnetic stimulation for urinary incontinence and bladder disease. Adv Exp Med Biol 2003;539(Pt A):453-65. [CrossRef] google scholar CR - Aslan E, Komurcu N, Beji NK, Yalcin O. Bladder training and Kegel exercises for women with urinary complaints living in a rest home. Gerontology 2008;54(4):224-31. [CrossRef] google scholar CR - Fall M, Lindström S. Electrical stimulation. A physiologic approach to the treatment of urinary incontinence. Urol Clin North Am 1991;18(2):393-407. [CrossRef] google scholar CR - Voorham-van der Zalm PJ, Pelger RCM, Stiggelbout AM, Elzevier HW, Lyclama à Nijeholt GAB. Effects of magnetic stimulation in the treatment of pelvic floor dysfunction. BJU Int 2006;97(5):1035-8. [CrossRef] google scholar CR - Galloway NT, El-Galey RE, Sand PK, Appell RA, Russell HW, Carlan SJ. Extracorporeal magnetic innervation therapy for stress urinary incontinence. Urology 1999;53(6):1108-11. [CrossRef] google scholar CR - Yamanishi T, Yasuda K, Suda S, Ishikawa N, Sakakibara R, Hattori T. Effect of functional continuous magnetic stimulation for urinary incontinence. J Urol 2000;163(2):456- 9. [CrossRef] google scholar CR - Chandi DD, Groenendijk PM, Venema PL. Functional extracorporeal magnetic stimulation as a treatment for female urinary incontinence: ‘the chair’. BJU Int 2004;93(4):539-42. [CrossRef] google scholar CR - Groenendijk PM, Halilovic M, Chandi D, Heesakkers JPFA, Vorrham-Van der Zalm PJ, Lycklama Anijeholt AAB. Extracorporeal magnetic innervation therapy: assessment of clinical efficacy in relation to urodynamic parameters. Scand J Urol Nephrol 2008;42(5):433-6. [CrossRef] google scholar CR - Yokoyama T, Fujita O, Nishiguchi J, Nozaki K, Nose H, Inoue M, et al. Extracorporeal magnetic innervation treatment for urinary incontinence. Int J Urol 2004;11(8):602-6. [CrossRef] google scholar CR - Almedia FG, Bruschini H, Srougi M. Urodynamic and clinical evaluation of 91 female patients with urinary incontinence treated with perineal magnetic stimulation: 1-year followup. J Urol 2004;171(4):1571-4. [CrossRef] google scholar CR - But I. Conservative treatment of female urinary incontinence with functional magnetic stimulation. Urology 2003;61(3):558-61. [CrossRef] google scholar CR - Bolukbas N, Vural M, Karan A, Yalcin O, Eskiyurt N. Effectiveness of functional magnetic versus electrical stimulation in women with urinary incontinence. Eura Medicophys 2005;41(4):297-301. google scholar CR - Fujishiro T, Enomoto H, Ugawa Y, Takahashi S, Ueno S, Kitamura T. Magnetic stimulation of the sacral roots for the treatment of stress incontinence: an investigational study and placebo controlled trial. J Urol 2000;164(4):1277-9. [CrossRef] google scholar CR - Gilling PJ, Wilson LC, Westenberg AM, McAllister WJ, Kennett KM, Frampton CM, et al. A double-blind randomized controlled trial of electromagnetic stimulation of the pelvic floor vs sham therapy in the treatment of women with stress urinary incontinence. BJUI 2009;103(10):1386-90. [CrossRef] google scholar CR - Lim R, Liong ML, Leong WS, Karim Khan NA, Yuen KH. Pulsed magnetic stimulation for stress urinary incontinence: 1-year follow-up results. J Urol. 2017;197(5):1302-8. [CrossRef] google scholar CR - Yamanishi T, Suzuki T, Sato R, Kaga K, Kaga M, Fuse M. Effects of magnetic stimulation on urodynamic stress incontinence refractory to pelvic floor muscle training in a randomized sham-controlled study. Low Urin Tract Symptoms 2019;11(1):61-5. [CrossRef] google scholar CR - Lim R, Lee SW, Tan PY, Liong ML, Yuen KH. Efficacy of electromagnetic therapy for urinary incontinence: a systematic review. Neurourol Urodyn 2015;34(8):713-22. [CrossRef] google scholar UR - https://doi.org/10.26650/IUITFD.1283129 L1 - https://dergipark.org.tr/en/download/article-file/3083773 ER -