Transcutaneous electrical nerve stimulation in the treatment of patients with poststroke urinary incontinence
Zhui-feng Guo,1,* Yi Liu,2,* Guang-hui Hu,1 Huan Liu,1 Yun-fei Xu1
1Department of Urology, 2Department of Neurology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Purpose: To investigate the therapeutic effect of transcutaneous electrical nerve stimulation (TENS) on poststroke urinary incontinence (UI).
Patients and methods: Sixty-one patients with poststroke UI were enrolled at the Neurology Department in the Shanghai Tenth People’s Hospital of Tongji University between January 2010–January 2011 and were divided into treatment and control groups (n=32 and n=29, respectively). TENS was applied to the treatment group, while the control group received basic therapy. The therapeutic group completed the whole set of TENS therapy with a treatment frequency of 30 minutes once a day for 60 days. The positive electrode was placed on the second lumbar spinous process, and the negative electrodes were inside the middle and lower third of the junction between the posterior superior iliac spine and ischia node. The overactive bladder symptom score, Barthel Index, and urodynamics examination were estimated before and after therapy in both groups.
Results: The daily micturition, nocturia, urgent urination, and urge UI in the treatment group significantly improved compared to the control group (P<0.05). The patients in the treatment group were superior in the self-care ability of daily living and also had an advantage over the indexes on maximum cystometry volume, flow rate, and the pressure of detrusor in the end of the filling phase.
Conclusion: TENS improved incontinence symptoms, enhanced the quality of life, and decreased adverse effects; hence, it is recommended in treating poststroke UI.
Keywords: stroke, urinary incontinence, OABSS, Barthel Index, urodynamics, transcutaneous electrical nerve stimulation