Percutaneous tibial nerve stimulation PTNS is a minimally invasive and effective therapy used both as first-line treatment, as well as in managing of unresponsive patients 8 , 9. Nevertheless, in common practice, antimuscarinic agents are frequently used as first treatment although burdened by a low adherence and although these patients need protracted treatment with periodic controls.
From September to May , 60 consecutive women mean age: All subjects previously underwent a detailed clinical evaluation, including a complete history and physical examination. The study was approved by the local ethics committee and all patients signed informed consent before starting treatment. In group A, women underwent pelvic floor rehabilitation.
The sessions were performed three times a week for one hour. ES was applied in short-term mode with vaginal probe for 30 minutes using biphasic square waves with 20Hz frequency for 30 sec.
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Every seat was individually followed by a physiotherapist and patients were carefully instructed to perform a correct pelvic muscle contraction. After the ten sessions, the patients continued the exercises at home for six months. All patients were assessed one month after the end of the treatments performed at the physiotherapy clinics.
Reduction in number of voids per 24 hours was considered the primary efficacy endpoint in this study.
How can electrical stimulation help my pelvic floor muscles? | de Smit Medical
The PGI-I is a validated generic tool for assessment of the overall improvement or deterioration that patients experience following the treatment. PGI-I was performed only at the end of treatment. Statistical analysis was performed using the MedCalc software package version Comparisons were carried out using the Wilcoxon test for paired samples, the Mann-Whitney for independent samples and the Chi square test X2 test. Data were assessed by a researcher not involved in the study protocol. All 60 patients enrolled in the two groups were evaluable at the end of the study.
No significant side effects were found with the two treatments. Anyway, the number of daily micturitions did not show significant differences when comparing the results obtained after therapy in the two groups of patients Table Nocturia and urge incontinence showed improvements in both groups with significant differences only in patients treated with PTNS.
Voided volume significantly improved in the two groups of patients with more evident results in the group treated with PTNS, also in the post treatment comparison. Improvements were found in PPIU-S in the two groups of patients with a statistically significant difference in women undergoing PTNS when the two groups were compared following treatment Table However, in common practice, antimuscarinic agents are frequently the first treatment considered for treating OAB 6 , but results have shown that a high percentage of patients treated with these drugs discontinued therapy 10 - Pelvic floor muscle training PFMT was popularized by Arnold Kegel in for the management of urinary incontinence 14 , and then it was also used in the treatment of urge incontinence and overactive bladder PFMT was used alone or in combination with behavioral and cognitive therapy 6 , vaginal cones, bladder training, ES, drug treatment, continence pessary, heat and steam generating sheet HSGS 17 and assisted with EMG-biofeedback PFMT has shown good results in reducing urge incontinence, urinary frequency and nocturia 15 , 18 - ES was particularly effective in the treatment of OAB symptoms 20 and is considered by some authors to be more effective than drug treatment, permitting an effective reduction or inhibition of detrusor activity by stimulating afferents of the pudendal nerve Randomized studies comparing PTNS versus anticholinergic agents have shown that the efficacy of PTNS is comparable or superior to anticholinergic agents in controlling OAB symptoms but with a better side effect profile 8 , 24 - To our knowledge, studies carried out comparing percutaneous tibial nerve stimulation with pelvic floor muscle training and electrical stimulation are not described in the literature.
The results of this study relate to the short term efficacy of these two different treatments. The data obtained, even though carried out on a moderate number of patients, highlight a complete adherence by all the women to the performed treatments. This is a result that should be emphasized as it is a chronic symptom for which great adherence to therapy is required by patients.
Watch out for other blogs in this series. This video tutorial by Jane Appleyard contains information about types of prolapse. It also explains how the Contrelle and Some of the common questions women ask are; Why do I find it so difficult to work out if Being a new mum is a pretty amazing experience. This blog is a lighthearted look at the journey through pregnancy along with some more serious facts about how Watch this video to be shown three simple ways to check your own pelvic floor muscles. To view our range How often have you been told to remember to practice your pelvic floor exercises?
How often have you nodded Most women start trying to do pelvic floor exercises without understanding anything about where these muscles are and what How can electrical stimulation help my pelvic floor muscles? Back to News How can electrical stimulation help my pelvic floor muscles? Is electrical stimulation better than exercises? Units have programmes that produce stimulation for varying lengths of time. Ideally the stimulation time should be built up slowly over a period of a few weeks. Use the stimulation for 5 minutes every day for the first week,10 minutes for the second week gradually building to minute sessions every day or every other day.
I think I have a prolapse! What exactly is Biofeedback? Plus some simple solutions Being a new mum is a pretty amazing experience.
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The three stages of pregnancy This blog is a lighthearted look at the journey through pregnancy along with some more serious facts about how Assess your own pelvic floor muscles How often have you been told to remember to practice your pelvic floor exercises? Figure out if you are a good candidate before proceeding with Botox or a rectal mucosal bulking agent. If initial therapy fails, doctor may recommend surgery. Specific procedures vary with type of pelvic floor disorder.
Surgery and Procedures. Nerve Stimulation Nerve stimulation sends small zaps of electrical current to your body.
The first step is a test stimulation during which your doctor will place a device outside your body lower back, near your tailbone to deliver stimulation through a wire implanted under your skin to see if the treatment relieves your symptoms. The SNS stimulator provides low-voltage stimulation to the sacral nerves. In many cases, this stimulation can improve the function of the bladder. The second step is to go about your daily life for several days, keeping track of how your bladder or bowel is functioning. And, lastly, if you notice significant improvement, you may be able to have a permanent device similar to a pacemaker implanted that delivers stimulation to the nerves in your back.
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The doctor places the stimulating wire in the permanent device in your lower back through a minor outpatient surgical procedure. Injections Botox toxin A, which is more commonly known for cosmetic surgery such as reducing facial wrinkles, is also an approved treatment for overactive bladder.
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