EFFICACY OF EXTRACORPOREAL ELECTROMAGNETIC STIMULATION FOR THE TREATMENT OF URINARY INCONTINENCE AND THE PREDICTIVE FACTORS FOR SATISFACTION

Öz

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.

Anahtar Kelimeler

• Electromagnetic stimulation
• mixed urinary incontinence
• overactive bladder syndrome
• quality of life
• stress urinary incontinence
• urinary incontinence

EKSTRAKORPOREAL ELEKTROMANYETİK STİMÜLASYONUN ÜRİNER İNKONTİNANS TEDAVİSİNDE ETKİNLİĞİ VE BAŞARIYI ETKİLEYEN FAKTÖRLERİN ANALİZİ

Öz

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.

Anahtar Kelimeler

• Elektromanyetik stimülasyon
• üriner inkontinans
• mikst üriner inkontinans
• stres üriner inkontinans
• aşırı aktif mesane
• hayat kalitesi

Kaynakça

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