Pulsed Magnetic Stimulation In The Treatment Of Stress Urinary Incontinence In Female Subjects
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Date
2016-04
Authors
Lim Renly
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Abstract
Pulsed magnetic stimulation (PMS) has been used as a non-surgical option
for stress urinary incontinence (SUI) since 1999 due to its established safety, noninvasiveness
and simplicity of treatment procedures. However, the Fifth International
Consultation on Incontinence (ICI) emphasised that the current evidence is
insufficient to guide any recommendation on its use for urinary incontinence, and
that well-powered randomised controlled trials are needed. Hence, the present study
aimed to evaluate the efficacy of PMS for SUI in a randomized, double-blind, shamcontrolled
trial. Prior to the above study, a systematic review was conducted to
appraise existing evidence on PMS for patients with urinary incontinence. The
results showed that PMS provided short-term improvement for incontinence
symptoms in women. However, in the absence of high quality trials, the applicability
of PMS as a treatment option for urinary incontinence remained uncertain. Thus, a
high-quality clinical trial protocol was designed to address the key limitations noted.
In the next part of the study, the questionnaires used to assess impact of SUI on
quality of life (International Consultation on Incontinence Questionnaire-Urinary
Incontinence Short Form (ICIQ-UI SF) and International Consultation on
Incontinence Questionnaire- Lower Urinary Tract Symptoms Quality of Life (ICIQLUTSqol))
and sexual function (Golombok Rust Inventory on Sexual Satisfaction
(GRISS)) were evaluated for their validity and reliability in the local population. All
questionnaires demonstrated satisfactory validity and reliability. During the study
period, a lack of interest on sexual function of couples with incontinence partners
was noted. Thus, a cross-sectional survey was conducted to investigate sexual
experience of couples with or without SUI partners. Additionally, the effects of PMS
on sexual function of SUI couples were also studied. The preliminary findings
suggested that effective treatment of female's SUI symptoms using PMS resulted in
simultaneous improvement in the sexual function of both partners. In the final part of
the study, a multicenter, randomized, double-blind, sham-controlled trial was
conducted. A total of 120 female SUI subject were randomized to receive either
active or sham PMS for 8 weeks. Treatment efficacy was assessed primarily using
the ICIQ-UI SF score. Active PMS was found to be 3.5 times more likely to improve
SUI symptoms compared with sham. During an additional 1-year of follow-up, the
present findings showed that such benefits were sustained over time. The
encouraging long-term response rates, high patient acceptance, desirable experience
and low dropout rates suggested that PMS is an attractive and promising non-surgical
alternative to patients who do not want to undergo surgery.
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Keywords
Pulsed magnetic stimulation (PMS) has been used as a non-surgical option , for stress urinary incontinence.