Department of Urology, Loma Linda University Medical Center, Loma Linda, CA, USA.
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Loma Linda University Medical Center, Loma Linda University, Loma Linda, CA, USA.
Investig Clin Urol. 2018 Jul;59(4):246-251. doi: 10.4111/icu.2018.59.4.246. Epub 2018 Jun 29.
Intravesical electrical stimulation treatment (IVES) has been successfully used to treat neurogenic bladder. We report the results of an observational study regarding the use of IVES for women with overactive bladder syndrome (OAB) and/or urgency urinary incontinence (UUI).
IVES was performed in women with OAB (defined by frequency ≥8/day, nocturia ≥2/night, or ≥3 episodes of UUI on 3-day voiding diary) who failed prior medical therapy. Subjects underwent 4 weeks of treatment with an 8-Fr Detruset™ IVES catheter. Primary outcome was Patient Global Impression of Improvement (PGI-I) at 3 months. Secondary outcomes included Visual Analog Scale (VAS), Short Form OAB Questionnaire (OAB-q SF), Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ), reduction in frequency and UUI on voiding diary, and adverse effects. Analysis was done with paired t-tests and Wilcoxon signed rank tests.
Seventeen subjects completed the study. At 4 weeks post-treatment, 15 improved on PGI-I (11 subjects: 'a little better', 2: 'much better', 2: 'very much better'). There were significant improvements in symptom bother and health-related quality of life as measured by OAB-q SF and pelvic organ prolapse and urinary distress as measured by PFDI. Frequency decreased from 10.3±4.3 at baseline to 8.9±2.3 (p=0.04) at 3 months. No pain was reported during treatment. There was one urinary tract infection during the study period. No other adverse events were reported.
IVES appears to be a safe and effective novel treatment for OAB. Larger comparative studies are needed to investigate its potential for long-term treatment.
经尿道电刺激治疗(IVES)已成功用于治疗神经性膀胱。我们报告了一项关于 IVES 治疗女性膀胱过度活动症(OAB)和/或急迫性尿失禁(UUI)的观察性研究结果。
IVES 用于 OAB(定义为每日频率≥8 次、夜间排尿≥2 次/夜或 3 天排尿日记中≥3 次 UUI)且先前药物治疗失败的女性。受试者接受 4 周的 8Fr Detruset™ IVES 导管治疗。主要结局为 3 个月时的患者总体改善印象(PGI-I)。次要结局包括视觉模拟量表(VAS)、简化膀胱过度活动症问卷(OAB-q SF)、盆底窘迫量表(PFDI)、盆底影响问卷(PFIQ)、排尿日记中频率和 UUI 的减少以及不良反应。分析采用配对 t 检验和 Wilcoxon 符号秩检验。
17 名受试者完成了研究。治疗 4 周后,15 名患者的 PGI-I 改善(11 名患者:“稍有改善”,2 名:“明显改善”,2 名:“非常明显改善”)。OAB-q SF 测量的症状困扰和健康相关生活质量以及 PFDI 测量的盆腔器官脱垂和尿失禁困扰均有显著改善。频率从基线时的 10.3±4.3 减少到 3 个月时的 8.9±2.3(p=0.04)。治疗期间无疼痛报告。研究期间发生 1 例尿路感染。无其他不良事件报告。
IVES 似乎是治疗 OAB 的一种安全有效的新方法。需要进行更大的比较研究来调查其长期治疗的潜力。