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胫后神经电刺激改善男性中风后神经源性膀胱过度活动症症状:一项随机对照试验。

Electrical stimulation of the posterior tibialis nerve improves symptoms of poststroke neurogenic overactive bladder in men: a randomized controlled trial.

作者信息

Monteiro Ébe Santos, de Carvalho Luciane Bizari Coin, Fukujima Marcia Maiumi, Lora Mayra Ivanoff, do Prado Gilmar Fernandes

机构信息

Department of Medicine, Universidade Federal de São Paulo-UNIFESP, São Paulo, São Paulo, Brazil.

Department of Neurology, Universidade Federal de São Paulo-UNIFESP, São Paulo, São Paulo, Brazil.

出版信息

Urology. 2014 Sep;84(3):509-14. doi: 10.1016/j.urology.2014.05.031.

Abstract

OBJECTIVE

To evaluate the effectiveness of electrical stimulation of the posterior tibialis nerve in men with neurogenic overactive bladder secondary to ischemic stroke at 45 days and 12 months after treatment.

MATERIALS AND METHODS

We studied 24 patients older than 18 years, with ischemic stroke that occurred between 6 months and 3 years previously and with no prior urinary symptoms. These patients were randomly allocated to receive electrical stimulation of the posterior tibialis nerve twice weekly for 6 weeks (treatment group, n = 12) or general advice and stretching sessions 1 to 3 times monthly for 6 weeks (control group, n = 12). Each session lasted 30 minutes in both groups. The primary outcomes were reduction in urinary frequency, reduction in urinary urgency, and overall improvement in voiding diary variables.

RESULTS

Patients in the electrical stimulation group, in relation to baseline and to control group, experienced improvement in urinary symptoms, reducing urinary urgency and frequency, and reported subjective improvement after treatment. This effect persisted after 12 months of follow-up. The patients with lesion in right hemisphere, advanced age, and with higher body mass index presented more chance to develop urinary symptoms.

CONCLUSION

Electrical stimulation of the posterior tibialis nerve is a safe and effective option for the treatment of poststroke neurogenic overactive bladder in men, reducing urinary frequency and urgency.

摘要

目的

评估治疗后45天及12个月时,胫后神经电刺激对缺血性卒中继发神经源性膀胱过度活动症男性患者的疗效。

材料与方法

我们研究了24例年龄超过18岁的患者,这些患者在6个月至3年前发生过缺血性卒中且既往无泌尿系统症状。将这些患者随机分为两组,一组接受每周两次的胫后神经电刺激,共6周(治疗组,n = 12);另一组接受每月1至3次的一般建议及伸展训练,共6周(对照组,n = 12)。两组每次治疗均持续30分钟。主要观察指标为尿频减少、尿急减少以及排尿日记变量的总体改善情况。

结果

与基线水平及对照组相比,电刺激组患者的泌尿系统症状得到改善,尿急和尿频减少,且治疗后报告主观症状有所改善。这种效果在随访12个月后仍然存在。右半球有病变、年龄较大且体重指数较高的患者出现泌尿系统症状的可能性更大。

结论

胫后神经电刺激是治疗男性卒中后神经源性膀胱过度活动症的一种安全有效的方法,可减少尿频和尿急。

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