Yamanishi T, Yasuda K
Chiba University School of Medicine, Japan.
Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(5):281-90. doi: 10.1007/BF01901508.
Electrical stimulation has been reported to be effective for stress incontinence, cure and improvement rates being reported to range from 30% to 50%, and from 6% to 90%, respectively. However, clinical application of this treatment is not common because there is little physiological and technical information. Electrodes for electrical stimulation are divided into two types: external (non-implantable) and internal (implantable), and there are two methods of stimulation: chronic (long-term, continuous) and short-term. Frequencies of 20-50 Hz, with a pulse duration of 1-5 ms, have been reported to be effective for urethral closure. The effectiveness of the treatment should be verified with placebo-controlled double-blinded trials, and four such studies using an active and a sham device have been reported. Two of these verified the superiority of the active device over the sham device, but the others did not demonstrate any significant difference between the two with regard to efficacy. Electrical stimulation has been reported to result in a long-term continuation of therapeutic effect. The effect has been explained as a re-education or a reactivation of lost functions of the pelvic floor muscles. As to adverse effects, there may be some complications in relation to anesthesia or surgical procedures, such as infection, pain and bleeding with implantable electrodes. The incidence of adverse effects in short-term electrical stimulation is less than 14%. In conclusion, short-term electrical stimulation using non-implantable anal or vaginal electrodes is the most recommendable because of safety and ease of use.
据报道，电刺激对应力性尿失禁有效，治愈率和改善率分别据报道在30%至50%以及6%至90%之间。然而，由于生理和技术信息较少，这种治疗方法在临床应用中并不常见。电刺激电极分为两种类型：外部（不可植入）和内部（可植入），刺激方法有两种：慢性（长期、连续）和短期。据报道，频率为20 - 50赫兹、脉冲持续时间为1 - 5毫秒对尿道闭合有效。该治疗的有效性应以安慰剂对照双盲试验进行验证，并且已经报道了四项使用有源和假装置的此类研究。其中两项验证了有源装置优于假装置，但其他研究在疗效方面未显示两者之间有任何显著差异。据报道，电刺激可导致治疗效果长期持续。这种效果被解释为盆底肌肉丧失功能的重新训练或重新激活。至于不良反应，与麻醉或手术操作相关可能会有一些并发症，如可植入电极引起的感染、疼痛和出血。短期电刺激的不良反应发生率低于14%。总之，由于安全性和易用性，使用不可植入的肛门或阴道电极进行短期电刺激是最值得推荐的。
