Department of Gynecology, IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy.
Department of Urology, ASST Santi Paolo e Carlo, San Paolo Hospital, 20142 Milano, Italy.
Medicina (Kaunas). 2023 Nov 14;59(11):1999. doi: 10.3390/medicina59111999.
: Strategies for overactive bladder syndrome (OAB) management involve, among others, strengthening the bladder outlet to suppress urgency and neuromodulating the sacral roots. Magnetic stimulation (MS) is a technology that involves an extracorporeal device that is able to provide an electromagnetic field specifically designed to interact with pelvic floor neuromuscular tissue. The resulting tissue electrical activity induces contraction of the pelvic muscle and neuromodulation of the S2-S4 sacral roots. Flat Magnetic Stimulation (FMS) is a relevant advancement involving homogeneous electromagnetic fields, which are able to optimize the effect on the entire pelvic area. However, the benefits of this new technology for OAB syndrome are poorly known. Consequently, the aim of our study is to analyze the outcomes and quality of life (QoL) impact of FMS with Dr. Arnold (DEKA, Calenzano, Italy) in women suffering from OAB syndrome associated with urinary incontinence. : This prospective study included patients with OAB, urge urinary incontinence, and no ongoing OAB treatments. At baseline (T0), the Incontinence Impact Questionnaire (IIQ-7), the Female Sexual Function Index (FSFI-19), and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were collected. Patients underwent 8 FMS sessions of 25 min each in one month. At the termination of the therapy (T1), women repeated the ICIQ-UI SF, FSFI-19, and IIQ-7 tools. Moreover, the Patient Global Impression of Improvement (PGI-I) questionnaire was collected to evaluate the cure rate. : Our study enrolled a total of 57 consecutive patients. Most women had at least one second- or third-line treatment before FMS, while the remaining naive patients had contraindications to pharmacological treatments. No women reported adverse effects during the treatment. After the treatment, we observed a decrease in the IIQ-7 ( < 0.001) and ICIQ-UI SF scores ( < 0.001) and an improvement in sexual function ( < 0.001) evaluated with FSFI-19. According to PGI-I scores, 42 (73.7%) women referred to some kind of improvement, scoring ≤ 3 points. Specifically, 8.7% of patients considered themselves very much improved, 29.8% much improved, 35.1% minimally improved, and 26.3% found no changes. FMS was effective in treating OAB symptoms without any adverse effects. The mechanism is supposed to be related to suppressing the initiation of micturition. This makes FMS a promising device for treating naive and refractory urge urinary incontinence. s: The new FMS represents a promising non-pharmacological option for the treatment of naive and refractory OAB.
:治疗膀胱过度活动症(OAB)的策略包括加强膀胱出口以抑制紧迫感和骶神经根神经调节。磁刺激(MS)是一种技术,涉及一种能够提供专门设计用于与盆底肌肉神经组织相互作用的电磁场的体外设备。由此产生的组织电活动引起盆底肌肉收缩和 S2-S4 骶神经根的神经调节。平面磁刺激(FMS)是一种相关的进步,涉及均匀的电磁场,能够优化对整个骨盆区域的影响。然而,这种新技术对 OAB 综合征的益处知之甚少。因此,我们的研究目的是分析使用 Dr. Arnold(DEKA,意大利卡尔泽诺)治疗 OAB 综合征伴尿失禁的女性的 FMS 的结果和生活质量(QoL)影响。
:这项前瞻性研究纳入了患有 OAB、急迫性尿失禁且无正在进行的 OAB 治疗的患者。在基线(T0)时,收集了失禁影响问卷(IIQ-7)、女性性功能指数(FSFI-19)和国际尿失禁咨询问卷-尿失禁简短表(ICIQ-UI SF)。患者在一个月内接受 8 次 25 分钟的 FMS 治疗。在治疗结束时(T1),女性重复使用 ICIQ-UI SF、FSFI-19 和 IIQ-7 工具。此外,还收集了患者整体改善印象(PGI-I)问卷以评估治愈率。
:我们的研究共纳入了 57 名连续患者。大多数女性在接受 FMS 治疗前至少接受了二线或三线治疗,而其余未接受过药物治疗的女性则有药物治疗的禁忌症。在治疗过程中,没有女性报告出现不良反应。治疗后,我们观察到 IIQ-7(<0.001)和 ICIQ-UI SF 评分(<0.001)降低,性功能(<0.001)改善,FSFI-19 评估。根据 PGI-I 评分,42 名(73.7%)女性报告了某种程度的改善,评分≤3 分。具体来说,8.7%的患者认为自己有很大改善,29.8%的患者有很大改善,35.1%的患者有轻微改善,26.3%的患者没有变化。FMS 治疗 OAB 症状有效,无任何不良反应。其机制可能与抑制排尿起始有关。这使得 FMS 成为治疗单纯性和难治性急迫性尿失禁的有前途的设备。