Fujishiro T, Enomoto H, Ugawa Y, Takahashi S, Ueno S, Kitamura T
Department of Urology, Sanraku Hospital, and Department of Neurology and Urology, Institute of Medical Electronics, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
J Urol. 2000 Oct;164(4):1277-9.
We designed an investigational study and placebo controlled trial to evaluate the potential efficacy of magnetic stimulation of the sacral roots for the treatment of stress incontinence.
A total of 75 patients with stress incontinence were studied. A 15 Hz. repetitive magnetic stimulation of the sacral roots with 50% intensity output and duration of 5 seconds per minute was applied for 30 minutes. Urodynamic investigations under magnetic stimulation were performed in 13 patients to evaluate acute effects to lower urinary tract function. There were 62 women (mean age 58 years) enrolled in a placebo controlled study to investigate the short-term efficacy of magnetic stimulation. The number of leaks for 3 days, amount of urine loss on a pad test and quality of life score were evaluated before and 1 week after stimulation.
The urodynamic investigations revealed an apparent elevation of urethral closure pressure induced by stimulation (mean 8.2 +/- 3.0 cm H2O, p = 0.0000004) and a significant increase in bladder capacity after stimulation (mean 40.0 +/- 51.0 ml., p = 0.0152). In the placebo controlled study the number of leaks and amount of urine loss on a pad test significantly decreased more in the active than in the sham stimulation group (p = 0.0023 and 0.0377, respectively). The quality of life score significantly improved in the active stimulation group (p = 0.0006) in contrast to no significant improvement in the sham stimulation group. The improvement rate in the active stimulation group was 74%, which was significantly higher than the 32% in the sham stimulation group (p = 0.0009). No adverse effects were noted in any patients.
These results suggest that magnetic stimulation of the sacral roots may be useful for the treatment of stress incontinence. Further studies are needed to evaluate the long-term efficacy of this potential treatment.
我们设计了一项研究性研究和安慰剂对照试验，以评估磁刺激骶神经根治疗压力性尿失禁的潜在疗效。
共研究了75例压力性尿失禁患者。采用15赫兹、50%强度输出、每分钟持续5秒的重复磁刺激骶神经根，持续30分钟。对13例患者进行磁刺激下的尿动力学研究，以评估对下尿路功能的急性影响。62名女性（平均年龄58岁）参加了一项安慰剂对照研究，以调查磁刺激的短期疗效。在刺激前和刺激后1周评估3天的漏尿次数、尿垫试验的尿量损失和生活质量评分。
尿动力学研究显示，刺激可使尿道闭合压明显升高（平均8.2±3.0厘米水柱，p = 0.0000004），刺激后膀胱容量显著增加（平均40.0±51.0毫升，p = 0.0152）。在安慰剂对照研究中，活动刺激组的漏尿次数和尿垫试验的尿量损失明显比假刺激组减少更多（分别为p = 0.0023和0.0377）。与假刺激组无明显改善相比，活动刺激组的生活质量评分显著改善（p = 0.0006）。活动刺激组的改善率为74%，明显高于假刺激组的32%（p = 0.0009）。所有患者均未出现不良反应。
这些结果表明，磁刺激骶神经根可能对治疗压力性尿失禁有用。需要进一步研究来评估这种潜在治疗方法的长期疗效。
