The efficacy of pelvic floor electrical stimulation on urinary dysfunction:a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Wei , SONG Yunling ,  TAN Botao

Department of Rehabilitation, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, P.R.China;

Corresponding?author：

TAN Botao, Email: tanbotao592@126.com

Keywords：

Pelvic floor electrical stimulation; Urination dysfunction; Efficacy; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.201809063

Video：

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Objectives To systematically review the efficacy of pelvic floor electrical stimulation on urinary dysfunction.Methods PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on the efficacy of pelvic floor electrical stimulation on urinary dysfunction from inception to August 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.Results A total of 9 RCTs involving 559 patients were included. The results of meta-analysis showed that the pelvic floor electrical stimulation group was superior to the control group in bladder volume before and after treatment(MD=79.25, 95%CI 40.36 to 118.15, P<0.000 1), residual urine volume (MD=35.50, 95%CI 7.60 to 63.41, P=0.01), maximum detrusor pressure (MD=5.19, 95%CI 2.11 to 8.27, P<0.001), number of leaks (RR=1.95, 95%CI 1.39 to 2.52, P<0.000 01), daily average urination frequency (RR=2.64, 95%CI 1.97 to 3.31, P<0.000 01), and international lower urinary tract score (MD=5.07, 95%CI 2.17 to 7.96, P=0.000 6).Conclusions Current evidence shows that pelvic floor electrical stimulation is an effective therapy for urinary dysfunction. Due to limited quality and quantity of the included studies, more high quality-studies are required to verify the above conclusion.

Citation： JIANG Wei, SONG Yunling, TAN Botao. The efficacy of pelvic floor electrical stimulation on urinary dysfunction:a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(4): 424-429. doi: 10.7507/1672-2531.201809063 Copy

1.	Makhmedzhanova FN, Apolikhina IA. Prevalence of urinary disorders and their relation to sexuality in women-point of view of gynecologist. Urologiia, 2013, (2): 9-11.
2.	Williams MP, Srikanth V, Bird M, et al. Urinary symptoms and natural history of urinary continence after first-ever stroke-a longitudinal population-based study. Age Ageing, 2012, 41(3): 371-376.
3.	Yum KS, Na SJ, Lee KY, et al. Pattern of voiding dysfunction after acute brainstem infarction. Eur Neurol, 2013, 70(5-6): 291-296.
4.	廖利民. 神經源性膀胱的治療現狀和進展. 中國康復醫學雜志, 2011, 26(3): 201-205.
5.	廖利民, 吳娟, 鞠彥合, 等. 脊髓損傷患者泌尿系管理與臨床康復指南. 中國康復理論與實踐, 2013, (4): 301-317.
6.	Wiener JS, Suson KD, Castillo J, et al. Bladder management and continence outcomes in adults with spina bifida: results from the national spina bifida patient registry 2009-15. J Urol, 2017, 10(12): 1-9.
7.	楊玉霞, 項蓉, 劉艷艷, 等. 十二井穴接經針刺配合膀胱功能訓練治療中風后尿潴留臨床研究. 中國針灸, 2017, 37(10): 1041-1044.
8.	Zachariou A, Filiponi M, Baltogiannis D, et al. Effective treatment of neurogenic detrusor overactivity in multiple sclerosis patients using desmopressin and mirabegron. Can J Urol, 2017, 24(6): 9107-9113.
9.	Eriksen BC, Bergmann S, Mj?lner?d OK. Effect of anal electrostimulation with the 'Incontan' device in women with urinary incontinence. Br J Obstet Gynaecol, 1987, 94(2): 147-156.
10.	Bent AE, Sand PK, Ostergard DR, et al. Transvaginal electrical stimulation in the treatment of genuine stress incontinence and detrusor instability. Intern Urol J, 1993, 4(1): 9-13.
11.	Shvarts PG, Borodulina IV, Fedin PA. The modern methods of the electrical stimulation for the management of neurogenic disturbances of urination. Vopr Kurortol Fizioter Lech Fiz Kult, 2015, 92(3): 18-21.
12.	Arnouk A, De E, Rehfuss A, et al. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep, 2017, 18(6): 47.
13.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
14.	Tomonori Y, Yasuda K, Sakakibara R, et al. Randomized, double-blind study of electrical stimulation for urinary incontinence due to detrusor overactivity. Urology, 2000, 55(3): 353-357.
15.	蔣東生, 車興旺, 范連彬, 等. 生物反饋技術結合膀胱功能訓練治療脊髓損傷患者排尿障礙. 臨床醫學, 2012, 32(8): 54-56.
16.	蔣瑋, 張茂舒, 譚波濤, 等. 盆底肌生物反饋電刺激對脊髓損傷后神經源性膀胱功能恢復的臨床研究. 第三軍醫大學學報, 2014, 36(16): 1725-1728.
17.	竇坤, 劉齊貴, 王躍力, 等. 盆底肌電刺激療法治療老年脊髓損傷后神經源性膀胱患者30例的療效. 中國老年學雜志, 2012, 32(2): 380-381.
18.	畢霞, 王雪強, 孫丹, 等. 盆底肌電刺激治療脊髓損傷后神經源性膀胱的療效觀察. 中國康復醫學雜志, 2011, 26(3): 206-209.
19.	楊美英, 藏苑彤, 吳麗娜, 等. 盆底肌電刺激治療脊髓損傷后神經源性膀胱的臨床研究. 內蒙古醫科大學學報, 2016, 38(S1): 189-191.
20.	朱寧, 馬奇, 張潔, 等. 針灸結合盆骶肌電刺激治療脊髓損傷神經源性膀胱的臨床觀察. 寧夏醫學雜志, 2017, 39(6): 553-555.
21.	馮俊鐸, 黃莉娟, 王毅. 間歇導尿結合生物反饋電刺激治療腦梗死后早期潴留的應用探討. 中國卒中雜志, 2016, 11(12): 1010-1013.
22.	蔣奇慧, 李晉芳, 張珂銘, 等. 盆底生物反饋電刺激治療缺血性腦卒中尿失禁患者的臨床觀察. 國際神經病學神經外科學雜志, 2017, 44(4): 379-382.
23.	Herrmann V, Potrick BA, Palma PC, et al. Transvaginal electrical stimulation of the pelvic floor in the treatment of stress urinary incontinence: clinical and ultrasonographic assessment. Rev Assoc Med Bras, 2003, 49(4): 401-405.
24.	李長思, 馬躍文. 生物刺激反饋儀治療脊髓損傷所致神經源性膀胱的治療效果. 中國醫科大學學報, 2013, 42(5): 469-471.
25.	Arruda RM, Castro RA, Sartori MG, et al. Clinical and urodynamic evaluation of women with detrusor instability before and after functional pelvic floor electrostimulation. Clin Exp Obstet Gynecol, 2003, 30(4): 220-222.
26.	那彥群. 中國泌尿外科疾病診斷治療指南手冊. 北京: 人民衛生出版社, 2014.
27.	Amarenco G, Sheikh Isma?l S, Chesnel C, et al. Diagnosis and clinical evaluation of neurogenic bladder. Eur J Phys Rehabil Med, 2017, 53(6): 975-980.
28.	Nambiar AK, Lemack GE, Chapple CR, et al. The role of urodynamics in the evaluation of urinary incontinence: The European association of urology recommendations in 2016. Eur Urol, 2017, 71(4): 501-503.
29.	魯功成, 曾甫清. 現代泌尿外科學. 武漢: 湖北科技出版社, 2003.
30.	陳忠, 崔喆, 雙衛兵. 神經源性膀胱. 北京: 人民衛生出版社, 2009.
31.	樓洪剛, 劉芳, 翟所迪. 氨溴索霧化吸入治療肺炎的系統評價. 中國循證醫學雜志, 2006, 6(6): 421-429.
32.	李艷玲, 趙濱, 劉慧敏. 低分子肝素皮下注射持續時間對不良反應影響的Meta分析. 中國實用護理雜志, 2014, 30(18): 59-62.

1. Makhmedzhanova FN, Apolikhina IA. Prevalence of urinary disorders and their relation to sexuality in women-point of view of gynecologist. Urologiia, 2013, (2): 9-11.
2. Williams MP, Srikanth V, Bird M, et al. Urinary symptoms and natural history of urinary continence after first-ever stroke-a longitudinal population-based study. Age Ageing, 2012, 41(3): 371-376.
3. Yum KS, Na SJ, Lee KY, et al. Pattern of voiding dysfunction after acute brainstem infarction. Eur Neurol, 2013, 70(5-6): 291-296.
4. 廖利民. 神經源性膀胱的治療現狀和進展. 中國康復醫學雜志, 2011, 26(3): 201-205.
5. 廖利民, 吳娟, 鞠彥合, 等. 脊髓損傷患者泌尿系管理與臨床康復指南. 中國康復理論與實踐, 2013, (4): 301-317.
6. Wiener JS, Suson KD, Castillo J, et al. Bladder management and continence outcomes in adults with spina bifida: results from the national spina bifida patient registry 2009-15. J Urol, 2017, 10(12): 1-9.
7. 楊玉霞, 項蓉, 劉艷艷, 等. 十二井穴接經針刺配合膀胱功能訓練治療中風后尿潴留臨床研究. 中國針灸, 2017, 37(10): 1041-1044.
8. Zachariou A, Filiponi M, Baltogiannis D, et al. Effective treatment of neurogenic detrusor overactivity in multiple sclerosis patients using desmopressin and mirabegron. Can J Urol, 2017, 24(6): 9107-9113.
9. Eriksen BC, Bergmann S, Mj?lner?d OK. Effect of anal electrostimulation with the 'Incontan' device in women with urinary incontinence. Br J Obstet Gynaecol, 1987, 94(2): 147-156.
10. Bent AE, Sand PK, Ostergard DR, et al. Transvaginal electrical stimulation in the treatment of genuine stress incontinence and detrusor instability. Intern Urol J, 1993, 4(1): 9-13.
11. Shvarts PG, Borodulina IV, Fedin PA. The modern methods of the electrical stimulation for the management of neurogenic disturbances of urination. Vopr Kurortol Fizioter Lech Fiz Kult, 2015, 92(3): 18-21.
12. Arnouk A, De E, Rehfuss A, et al. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep, 2017, 18(6): 47.
13. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
14. Tomonori Y, Yasuda K, Sakakibara R, et al. Randomized, double-blind study of electrical stimulation for urinary incontinence due to detrusor overactivity. Urology, 2000, 55(3): 353-357.
15. 蔣東生, 車興旺, 范連彬, 等. 生物反饋技術結合膀胱功能訓練治療脊髓損傷患者排尿障礙. 臨床醫學, 2012, 32(8): 54-56.
16. 蔣瑋, 張茂舒, 譚波濤, 等. 盆底肌生物反饋電刺激對脊髓損傷后神經源性膀胱功能恢復的臨床研究. 第三軍醫大學學報, 2014, 36(16): 1725-1728.
17. 竇坤, 劉齊貴, 王躍力, 等. 盆底肌電刺激療法治療老年脊髓損傷后神經源性膀胱患者30例的療效. 中國老年學雜志, 2012, 32(2): 380-381.
18. 畢霞, 王雪強, 孫丹, 等. 盆底肌電刺激治療脊髓損傷后神經源性膀胱的療效觀察. 中國康復醫學雜志, 2011, 26(3): 206-209.
19. 楊美英, 藏苑彤, 吳麗娜, 等. 盆底肌電刺激治療脊髓損傷后神經源性膀胱的臨床研究. 內蒙古醫科大學學報, 2016, 38(S1): 189-191.
20. 朱寧, 馬奇, 張潔, 等. 針灸結合盆骶肌電刺激治療脊髓損傷神經源性膀胱的臨床觀察. 寧夏醫學雜志, 2017, 39(6): 553-555.
21. 馮俊鐸, 黃莉娟, 王毅. 間歇導尿結合生物反饋電刺激治療腦梗死后早期潴留的應用探討. 中國卒中雜志, 2016, 11(12): 1010-1013.
22. 蔣奇慧, 李晉芳, 張珂銘, 等. 盆底生物反饋電刺激治療缺血性腦卒中尿失禁患者的臨床觀察. 國際神經病學神經外科學雜志, 2017, 44(4): 379-382.
23. Herrmann V, Potrick BA, Palma PC, et al. Transvaginal electrical stimulation of the pelvic floor in the treatment of stress urinary incontinence: clinical and ultrasonographic assessment. Rev Assoc Med Bras, 2003, 49(4): 401-405.
24. 李長思, 馬躍文. 生物刺激反饋儀治療脊髓損傷所致神經源性膀胱的治療效果. 中國醫科大學學報, 2013, 42(5): 469-471.
25. Arruda RM, Castro RA, Sartori MG, et al. Clinical and urodynamic evaluation of women with detrusor instability before and after functional pelvic floor electrostimulation. Clin Exp Obstet Gynecol, 2003, 30(4): 220-222.
26. 那彥群. 中國泌尿外科疾病診斷治療指南手冊. 北京: 人民衛生出版社, 2014.
27. Amarenco G, Sheikh Isma?l S, Chesnel C, et al. Diagnosis and clinical evaluation of neurogenic bladder. Eur J Phys Rehabil Med, 2017, 53(6): 975-980.
28. Nambiar AK, Lemack GE, Chapple CR, et al. The role of urodynamics in the evaluation of urinary incontinence: The European association of urology recommendations in 2016. Eur Urol, 2017, 71(4): 501-503.
29. 魯功成, 曾甫清. 現代泌尿外科學. 武漢: 湖北科技出版社, 2003.
30. 陳忠, 崔喆, 雙衛兵. 神經源性膀胱. 北京: 人民衛生出版社, 2009.
31. 樓洪剛, 劉芳, 翟所迪. 氨溴索霧化吸入治療肺炎的系統評價. 中國循證醫學雜志, 2006, 6(6): 421-429.
32. 李艷玲, 趙濱, 劉慧敏. 低分子肝素皮下注射持續時間對不良反應影響的Meta分析. 中國實用護理雜志, 2014, 30(18): 59-62.

Chinese Journal of Evidence-Based Medicine

The efficacy of pelvic floor electrical stimulation on urinary dysfunction:a meta-analysis

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