经皮胫后神经电刺激治疗急迫性尿失禁和大便失禁
[Percutaneous posterior tibial nerve electrostimulation in urge urinary incontinence and faecal incontinence].
作者信息
Álamo Vera V, González Oria M O, Carvajal Ramos E, Murciano Casas M P, Guillen Haynes C, García Obrero M I
机构信息
Unidad de Gestión Clínica de Rehabilitación, Hospital Universitario Virgen del Rocío, Sevilla, España.
Unidad de Gestión Clínica de Rehabilitación, Hospital Universitario Virgen del Rocío, Sevilla, España.
出版信息
Rehabilitacion (Madr). 2020 Jan-Mar;54(1):3-10. doi: 10.1016/j.rh.2019.06.005. Epub 2019 Jul 31.
OBJECTIVE
The main aim of this study was to assess the efficacy of percutaneous posterior tibial nerve electrostimulation (P-PTNS) in urge urinary incontinence (UUI) and faecal incontinence (FI) refractory to first-line treatment. A secondary aim was to identify predictors of treatment response. To do this, we performed a 2-year analytical, longitudinal and prospective study in patients with UUI and FI treated with P-PTNS.
MATERIAL AND METHODS
We included patients with UUI and FI who were treated with P-PTNS and who completed the bladder/faecal incontinence diary and severity and quality of life questionnaires. We excluded patients with neurogenic UUI and those who abandoned treatment or did not complete the questionnaires. We assessed demographic and clinical variables (micturition/defecation habits pre- and postreatment), severity scales before and after treatment (ICIQ-SF, Sandvick and Wexner), subjective improvement and quality of life (IQOL and FIQL pre- and postreatment). The statistical analysis was conducted using SPSS v19.
RESULTS
The sample consisted of 21 patients divided into 2 groups: -UUI group, 9 patients. After P-PTNS, there was a statistically significant improvement in diurnal (p=.018) and nocturnal (p=.016) urinary frequency, urgencies/day (p=.018), urine leakage/day (p=.027), ICIQ-SF and Sandvick (p=.018), and IQOL (p=.012). This improvement was related to exercise (p=.039) and prolapse (p=.05). -Group FI, 12 patients. After P-PTNS, there was a statistically significant improvement in defecation frequency (p=.027), incontinence (p=.012), Wexner scale (p=.007), and FIQL in its 4 dimensions (lifestyle, behaviour, embarrassment p=.005; and depression p=.008). This improvement was related to age (p=.048), time since onset (p=.044) and prolapse (p=.026).
CONCLUSIONS
The P-PTNS is effective in UUI and FI refractory to conventional treatment. Treatment response is affected by several factors.
目的
本研究的主要目的是评估经皮胫后神经电刺激（P-PTNS）对一线治疗无效的急迫性尿失禁（UUI）和大便失禁（FI）的疗效。次要目的是确定治疗反应的预测因素。为此，我们对接受P-PTNS治疗的UUI和FI患者进行了一项为期2年的分析性、纵向和前瞻性研究。
材料与方法
我们纳入了接受P-PTNS治疗并完成膀胱/大便失禁日记以及严重程度和生活质量问卷的UUI和FI患者。我们排除了神经源性UUI患者以及放弃治疗或未完成问卷的患者。我们评估了人口统计学和临床变量（治疗前后的排尿/排便习惯）、治疗前后的严重程度量表（ICIQ-SF、Sandvick和Wexner）、主观改善情况和生活质量（治疗前后的IQOL和FIQL）。使用SPSS v19进行统计分析。
结果
样本包括21名患者，分为2组：-UUI组，9名患者。P-PTNS治疗后，日间（p = 0.018）和夜间（p = 0.016）尿频、每日尿急次数（p = 0.018）、每日漏尿量（p = 0.027）、ICIQ-SF和Sandvick（p = 0.018）以及IQOL（p = 0.012）有统计学显著改善。这种改善与运动（p = 0.039）和脱垂（p = 0.05）有关。-FI组，12名患者。P-PTNS治疗后，排便频率（p = 0.027）、失禁情况（p = 0.012）、Wexner量表（p = 0.007）以及FIQL的4个维度（生活方式、行为、尴尬p = 0.005；抑郁p = 0.008）有统计学显著改善。这种改善与年龄（p = 0.048）、发病时间（p = 0.044）和脱垂（p = 0.026）有关。
结论
P-PTNS对传统治疗无效的UUI和FI有效。治疗反应受多种因素影响。
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