Galloway N T, El-Galley R E, Sand P K, Appell R A, Russell H W, Carlin S J
Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.
Urology. 2000 Dec 4;56(6 Suppl 1):82-6. doi: 10.1016/s0090-4295(00)00686-5.
Pulsed magnetic technology has been developed for pelvic floor muscle strengthening for the treatment of urinary incontinence. This report includes an update of the prospective multicenter study of extracorporeal magnetic innervation (ExMI) therapy for stress incontinence and a discussion of the possible mechanisms of action. Issues of patient selection for ExMI therapy will also be discussed. One hundred and eleven women with demonstrable stress urinary incontinence were studied. The mean age was 55 +/- 13 years, and the mean duration of symptoms was 11 years. Ninety-seven completed ExMI therapy and analysis. Evaluation before treatment included bladder diaries, dynamic pad weight test, urodynamics, and a quality-of-life survey. For treatment the patients were seated fully clothed in a Neocontrol chair with a magnetic field therapy head in the seat. Treatment sessions were for 20 minutes, twice a week, for 6 weeks. After ExMI therapy, all of the measures were repeated at 8 weeks, including the dynamic pad weight testing and quality-of-life survey. At 6 months, further data were added, including repeat bladder diary, pad use, and quality-of-life survey. Forty-seven women completed 6 months of follow-up; of the 47, 13 patients were completely dry (28%) and 25 used no pad or less than 1 pad per day (53%). Pad use was reduced in 33 patients (70%). The median number of pads was reduced from 2.16 to 1 per day (Wilcoxon signed rank test, P <0.005). The frequency of leak episodes was reduced from 3.0 to 1.7 at 6 months (Wilcoxon signed rank test, P = 0.004). Detrusor instability was demonstrated in 10 before and 6 after ExMI (P <0.05). ExMI offers an alternative approach for the treatment of urinary incontinence. ExMI therapy is effective for both stress and urge incontinence. The best results are achieved in those patients who use no more than 3 pads a day and have had no prior continence surgery.
脉冲磁技术已被开发用于加强盆底肌肉以治疗尿失禁。本报告包括体外磁神经支配（ExMI）疗法治疗压力性尿失禁的前瞻性多中心研究的更新内容以及对可能作用机制的讨论。还将讨论ExMI疗法的患者选择问题。对111名有明显压力性尿失禁的女性进行了研究。平均年龄为55±13岁，平均症状持续时间为11年。97名患者完成了ExMI疗法及分析。治疗前评估包括膀胱日记、动态护垫重量测试、尿动力学和生活质量调查。治疗时，患者穿着全套衣服坐在带有磁场治疗头的Neocontrol椅子上。治疗疗程为20分钟，每周两次，共6周。ExMI疗法后，在8周时重复所有测量，包括动态护垫重量测试和生活质量调查。在6个月时，增加了进一步的数据，包括重复膀胱日记、护垫使用情况和生活质量调查。47名女性完成了6个月的随访；在这47名患者中，13名患者完全干爽（28%），25名患者每天不使用护垫或使用少于1片护垫（53%）。33名患者（70%）的护垫使用量减少。护垫的中位数从每天2.16片减少到1片（Wilcoxon符号秩检验，P<0.005）。6个月时漏尿次数从3.0次减少到1.7次（Wilcoxon符号秩检验，P = 0.004）。ExMI治疗前有10名患者存在逼尿肌不稳定，治疗后有6名患者存在逼尿肌不稳定（P<0.05）。ExMI为尿失禁治疗提供了一种替代方法。ExMI疗法对压力性和急迫性尿失禁均有效。在那些每天使用不超过3片护垫且未接受过先前控尿手术的患者中可取得最佳效果。
