磁刺激与电刺激对抑制逼尿肌过度活动效果的比较研究

Comparative study of the effects of magnetic versus electrical stimulation on inhibition of detrusor overactivity.

作者信息

Yamanishi T, Sakakibara R, Uchiyama T, Suda S, Hattori T, Ito H, Yasuda K

机构信息

Department of Urology, Chiba University School of Medicine, Chiba, Japan.

出版信息

Urology. 2000 Nov 1;56(5):777-81. doi: 10.1016/s0090-4295(00)00779-2.

DOI:10.1016/s0090-4295(00)00779-2

PMID:11068300

Abstract

OBJECTIVES

To perform a randomized comparative study investigating the urodynamic effects of functional magnetic stimulation (FMS) and functional electrical stimulation (FES) on the inhibition of detrusor overactivity.

METHODS

Thirty-two patients with urinary incontinence due to detrusor overactivity (15 men, 17 women; age 62. 3 +/- 16.6 years) were randomly assigned to two treatment groups (15 patients in the FMS group and 17 in the FES group). Stimulation was applied continuously at 10 Hz in both groups. For FMS, the magnetic stimulator unit was set on an armchair type seat and had a concave-shaped coil, so that the patients could sit during stimulation. For FES, a vaginal electrode was used in the women and a surface electrode on the dorsal part of the penis was used in the men. Cystometry was performed before and during the stimulation.

RESULTS

The bladder capacity at the first desire to void and the maximum cystometric capacity increased significantly during stimulation compared with prestimulation levels in both groups (P = 0.0054 and 0.0026, respectively, in the FMS group and P = 0.0015 and 0.0229, respectively, in the FES group). However, the increase in the maximum cystometric capacity was significantly (P = 0.0135) greater in the FMS group (114.2 +/- 124.1 mL or an increase of 105. 5% +/- 130.4% compared with the pretreatment level) than that in the FES group (32.3 +/- 56.6 mL or an increase of 16.3% +/- 33.9%). Detrusor overactivity was abolished in 3 patients in the FMS group but not in any patient in the FES group.

CONCLUSIONS

Although both treatments were effective, the inhibition of detrusor overactivity appeared greater in the FMS group than in the FES group.

摘要

目的

进行一项随机对照研究，调查功能性磁刺激（FMS）和功能性电刺激（FES）对抑制逼尿肌过度活动的尿动力学影响。

方法

32例因逼尿肌过度活动导致尿失禁的患者（15例男性，17例女性；年龄62.3±16.6岁）被随机分为两个治疗组（FMS组15例患者，FES组17例患者）。两组均以10Hz的频率持续施加刺激。对于FMS，磁刺激装置设置在扶手椅式座椅上，并配有凹形线圈，以便患者在刺激过程中能够坐着。对于FES，女性使用阴道电极，男性使用阴茎背部的表面电极。在刺激前和刺激过程中进行膀胱测压。

结果

与刺激前水平相比，两组在首次有排尿欲望时的膀胱容量和最大膀胱测压容量在刺激过程中均显著增加（FMS组分别为P = 0.0054和0.0026，FES组分别为P = 0.0015和0.0229）。然而，FMS组最大膀胱测压容量的增加显著更大（P = 0.0135）（与治疗前水平相比增加了114.2±124.1mL或105.5%±130.4%），高于FES组（32.3±56.6mL或16.3%±33.9%）。FMS组有3例患者的逼尿肌过度活动被消除，而FES组无任何患者的逼尿肌过度活动被消除。