Lim Renly, Lee Shaun Wen Huey, Tan Ping Yee, Liong Men Long, Yuen Kah Hay
School of Pharmaceutical Sciences, University of Science Malaysia, USM, Penang, Malaysia.
School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
Neurourol Urodyn. 2015 Nov;34(8):713-22. doi: 10.1002/nau.22672. Epub 2014 Sep 22.
To review whether patients with urinary incontinence (UI) treated with magnetic stimulation (MS) have a higher continence rate compared to sham.
Computerized search of electronic databases was performed using the keywords magnetic stimulation therapy and urinary incontinence. Inclusion criteria were randomized, blinded and sham-controlled.
Eight studies involving 494 patients were included (285 patients received active MS and 209 patients received sham MS). Sample size ranged from 20 to 151 participants. Three studies were on stress UI, two studies on urgency UI, two studies on mixed UI and one study on overactive bladder. The primary outcome (cure) was not reported since only one study reported this outcome. Meta-analysis of the secondary outcome (improvement) showed patients who received active treatment were 2.3 times more likely to experience improved continence compared to sham treatment (95% confidence interval: 1.60-3.29; P < 0.001), but was subject to bias due to varying inclusion criteria, poor reporting and variable time points. There were conflicting results in the treatment effect on quality of life (QOL). Twenty out of 494 patients (5%) experienced mild side effects. The longest follow up period was six months.
There is no firm evidence to support the benefits of using MS in the management of UI, although short-term outcomes suggests that MS improves UI symptoms in women. The applicability of MS as a treatment option for UI remains uncertain until larger, high-quality trials with longer follow-up periods using comparable and relevant outcomes are conducted.
探讨与假刺激相比,接受磁刺激(MS)治疗的尿失禁(UI)患者是否有更高的控尿率。
使用关键词“磁刺激疗法”和“尿失禁”对电子数据库进行计算机检索。纳入标准为随机、盲法和假刺激对照。
纳入八项研究,共494例患者(285例接受主动磁刺激,209例接受假磁刺激)。样本量从20至151名参与者不等。三项研究针对压力性尿失禁,两项研究针对急迫性尿失禁,两项研究针对混合性尿失禁,一项研究针对膀胱过度活动症。由于只有一项研究报告了主要结局(治愈),因此未进行相关报道。对次要结局(改善)的荟萃分析显示,与假刺激治疗相比,接受主动治疗的患者控尿改善的可能性高2.3倍(95%置信区间:1.60 - 3.29;P < 0.001),但由于纳入标准不同、报告不佳和时间点可变,存在偏倚。在对生活质量(QOL)的治疗效果方面存在相互矛盾的结果。494例患者中有20例(5%)出现轻度副作用。最长随访期为六个月。
尽管短期结果表明磁刺激可改善女性尿失禁症状,但尚无确凿证据支持使用磁刺激治疗尿失禁的益处。在进行更大规模、高质量且随访期更长并使用可比且相关结局的试验之前,磁刺激作为尿失禁治疗选择的适用性仍不确定。