Encouraging experimental and clinical results have been achieved in some
types
of
urinary
incontinence
with
electrostimulation.
The
aim
of
the
present
study
was
to
analyse
the
effectiveness
of
home-managed
electrostimulation
when
the
method
was
implemented
as
common
practice
in
a
population.
Methods
The study was conducted as a prospective cohort study of all 3198 women
treated
with
home-managed
electrostimulation
in
Norway
1992-1994.
Data
were
collected
from
both
patients
and
physicians
by
questionnaires
before
and
after
treatment.
The
first
patient
questionnaire
covered
the
incontinence
symptoms
pre-treatment,
the
second
experiences
during
treatment
and
changes
in
symptoms.
The
physician
completed
the
request
form
which
included
information
about
the
patient,
diagnosis
and
clinical
findings,
and
the
kind
of
stimulator
required.
Adding
to
this
they
completed
a
questionnaire
for
each
patient
after
the
treatment
was
ended,
describing
reasons
for
choosing
this
particular
electrostimulator,
practical
experiences,
and
results
of
treatment.
43,
15,
37
and
5%
of
the
patients
had
stress,
urge,
mixed
incontinence,
and
other
diagnoses,
respectively.
After
exclusion
of
patients
with
other
diagnoses
than
urinary
incontinence,
and
patients
who
should
not
be
treated
by
stimulator,
3008
women
with
urinary
incontinence
remained
for
our
analysis.
The
median
age
was
51
years,
mean
53
(SD
14),
and
range
14-95
years.
47%
were
treated
by
short-term
maximal
(low
frequency)
and
53%
by
long-term
(high
frequency)
electrostimulation.
From these 3008 women we have complete baseline information about all (100%),
2720
(90%)
patients
returned
the
first
questionnaire,
and
2164
(72%)
the
second.
2092
(70%)
answered
both
questionnaires.
The
physicians
returned
questionnaires
after
treatment
for
2191
(73%)
of
the
patients.
Results
29% of the women were cured or much improved according to their
own
assessment;
altogether
61%
were
improved
(Table
I).
According
to
the
physicians’
assessment,
33%
were
cured
or
much
improved;
a
total
of
55%
were
improved
(63%,
when
excluding
the
physicians
who
didn’t
know).
37%
of
compliers
and
12%
of
non-compliers
regarded
themselves
as
cured
or
much
improved.
The
number
of
incontinence
episodes,
amount
of
leakage,
and
use
of
pads
decreased
significantly.
44%
had
less
severe
incontinence
than
before
treatment
according
to
a
validated
severity
index.
Conclusions
Women
treated
with
electrostimulation
for
urinary
incontinence
experienced
a
significant
reduction
of
incontinence
problems
both
subjectively
and
semi-objectively.
The
treatment
results
seem
to
be
strongly
dependent
on
good
acceptance
of
the
treatment.
Table
I.
Treatment
results
(%)
according
to
patients
and
doctors.
Percentages
are
given
with
all
patients
included
(intention
to
treat)
and
for
patients
with
data
available
for
analysis.
The
last
group
is
then
divided
into
compliers
and
non-compliers.
|
|
|
|
Non-compliers
|
Compliers
|
|
Treatment
results
|
Doctor
|
Patient
|
Doctor
|
Patient
|
Doctor
|
Patient
|
Doctor
|
Patient
|
|
Cured
|
7
|
4
|
10
|
6
|
1
|
2
|
14
|
8
|
|
Much
better
|
16
|
16
|
23
|
23
|
8
|
10
|
29
|
29
|
|
Some
improvement
|
15
|
22
|
22
|
32
|
21
|
32
|
23
|
31
|
|
Unchanged
|
21
|
24
|
32
|
36
|
48
|
51
|
25
|
29
|
|
Worse
|
1
|
2
|
1
|
3
|
1
|
5
|
1
|
3
|
|
Don’t
know
|
8
|
-
|
12
|
-
|
21
|
-
|
8
|
-
|
|
Missing
|
32
|
32
|
-
|
-
|
-
|
-
|
-
|
-
|
|
Number
of
patients
|
3008
|
3008
|
2044
|
2045
|
605
|
665
|
1439
|
1380
|
|
|
|
|
|
|
|
|
|
|
