In this study, the combination of external electrical stimulation (EES) with pelvic floor muscle training (PFMT) was assessed to determine if it yielded better results than PFMT or EES alone for treatment of stress urinary incontinence (SUI).
Fifty-one women with SUI were randomly allocated to EES + PFMT (n = 17), PFMT (n = 17), or EES groups (n = 17) for 8 weeks of treatment. Personal, demographic, and clinical characteristics of the patients were recorded. Outcome measures included self-reported improvement, severity of incontinence, symptom distress, quality of life (QOL), urinary incontinence episodes, pelvic floor muscle strength (PFMS) and endurance (PFME) and dysfunction. All evaluations were made pre- and posttreatment. Data were analyzed using the Chi-square, marginal homogeneity, Kruskal-Wallis, Wilcoxon signed-rank or paired t test and Dunn-Bonferroni post hoc tests.
In the 8th week, there were significant changes in self-reported improvement, severity of incontinence, symptom distress score, urinary incontinence episodes, PFMS, PFME, pelvic floor dysfunction and all areas of QoL in all groups (p < 0.05). Combined therapy was not superior to PFMT and EES for overall outcome measures, except for the incontinence impact subdomain of the QoL score (p < 0.05).
Our study supports the idea that PFMT should be preferred as the first line therapy for women with SUI. However, the acceptable EES method can be recommended in addition to PFMT to increase motivation and treatment compliance in patients with insufficient or inaccurate pelvic floor muscle contractions.
Neurourology and urodynamics. 2022 Aug 18 [Epub ahead of print]
Ulku Kezban Sahin, Sevim Acaröz, Abdullah Çirakoğlu, Erdal Benli, Türkan Akbayrak
Department of Therapy and Rehabilitation, Vocational School of Health Services, Giresun University, Giresun, Turkey., Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Ordu University, Ordu, Turkey., Department of Urology, Faculty of Medicine, Ordu University, Ordu, Turkey., Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.