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. 神经源性膀胱的治疗现状和进展. 中国康复医学杂志, 2011, 26(3): 201-205.
5.	廖利民, 吴娟, 鞠彦合, 等. 脊髓损伤患者泌尿系管理与临床康复指南. 中国康复理论与实践, 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.	杨玉霞, 项蓉, 刘艳艳, 等. 十二井穴接经针刺配合膀胱功能训练治疗中风后尿潴留临床研究. 中国针灸, 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, Mjølnerød 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.	蒋东生, 车兴旺, 范连彬, 等. 生物反馈技术结合膀胱功能训练治疗脊髓损伤患者排尿障碍. 临床医学, 2012, 32(8): 54-56.
16.	蒋玮, 张茂舒, 谭波涛, 等. 盆底肌生物反馈电刺激对脊髓损伤后神经源性膀胱功能恢复的临床研究. 第三军医大学学报, 2014, 36(16): 1725-1728.
17.	窦坤, 刘齐贵, 王跃力, 等. 盆底肌电刺激疗法治疗老年脊髓损伤后神经源性膀胱患者30例的疗效. 中国老年学杂志, 2012, 32(2): 380-381.
18.	毕霞, 王雪强, 孙丹, 等. 盆底肌电刺激治疗脊髓损伤后神经源性膀胱的疗效观察. 中国康复医学杂志, 2011, 26(3): 206-209.
19.	杨美英, 藏苑彤, 吴丽娜, 等. 盆底肌电刺激治疗脊髓损伤后神经源性膀胱的临床研究. 内蒙古医科大学学报, 2016, 38(S1): 189-191.
20.	朱宁, 马奇, 张洁, 等. 针灸结合盆骶肌电刺激治疗脊髓损伤神经源性膀胱的临床观察. 宁夏医学杂志, 2017, 39(6): 553-555.
21.	冯俊铎, 黄莉娟, 王毅. 间歇导尿结合生物反馈电刺激治疗脑梗死后早期潴留的应用探讨. 中国卒中杂志, 2016, 11(12): 1010-1013.
22.	蒋奇慧, 李晋芳, 张珂铭, 等. 盆底生物反馈电刺激治疗缺血性脑卒中尿失禁患者的临床观察. 国际神经病学神经外科学杂志, 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.	李长思, 马跃文. 生物刺激反馈仪治疗脊髓损伤所致神经源性膀胱的治疗效果. 中国医科大学学报, 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.	那彦群. 中国泌尿外科疾病诊断治疗指南手册. 北京: 人民卫生出版社, 2014.
27.	Amarenco G, Sheikh Ismaël 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.	鲁功成, 曾甫清. 现代泌尿外科学. 武汉: 湖北科技出版社, 2003.
30.	陈忠, 崔喆, 双卫兵. 神经源性膀胱. 北京: 人民卫生出版社, 2009.
31.	楼洪刚, 刘芳, 翟所迪. 氨溴索雾化吸入治疗肺炎的系统评价. 中国循证医学杂志, 2006, 6(6): 421-429.
32.	李艳玲, 赵滨, 刘慧敏. 低分子肝素皮下注射持续时间对不良反应影响的Meta分析. 中国实用护理杂志, 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. 神经源性膀胱的治疗现状和进展. 中国康复医学杂志, 2011, 26(3): 201-205.
5. 廖利民, 吴娟, 鞠彦合, 等. 脊髓损伤患者泌尿系管理与临床康复指南. 中国康复理论与实践, 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. 杨玉霞, 项蓉, 刘艳艳, 等. 十二井穴接经针刺配合膀胱功能训练治疗中风后尿潴留临床研究. 中国针灸, 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, Mjølnerød 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. 蒋东生, 车兴旺, 范连彬, 等. 生物反馈技术结合膀胱功能训练治疗脊髓损伤患者排尿障碍. 临床医学, 2012, 32(8): 54-56.
16. 蒋玮, 张茂舒, 谭波涛, 等. 盆底肌生物反馈电刺激对脊髓损伤后神经源性膀胱功能恢复的临床研究. 第三军医大学学报, 2014, 36(16): 1725-1728.
17. 窦坤, 刘齐贵, 王跃力, 等. 盆底肌电刺激疗法治疗老年脊髓损伤后神经源性膀胱患者30例的疗效. 中国老年学杂志, 2012, 32(2): 380-381.
18. 毕霞, 王雪强, 孙丹, 等. 盆底肌电刺激治疗脊髓损伤后神经源性膀胱的疗效观察. 中国康复医学杂志, 2011, 26(3): 206-209.
19. 杨美英, 藏苑彤, 吴丽娜, 等. 盆底肌电刺激治疗脊髓损伤后神经源性膀胱的临床研究. 内蒙古医科大学学报, 2016, 38(S1): 189-191.
20. 朱宁, 马奇, 张洁, 等. 针灸结合盆骶肌电刺激治疗脊髓损伤神经源性膀胱的临床观察. 宁夏医学杂志, 2017, 39(6): 553-555.
21. 冯俊铎, 黄莉娟, 王毅. 间歇导尿结合生物反馈电刺激治疗脑梗死后早期潴留的应用探讨. 中国卒中杂志, 2016, 11(12): 1010-1013.
22. 蒋奇慧, 李晋芳, 张珂铭, 等. 盆底生物反馈电刺激治疗缺血性脑卒中尿失禁患者的临床观察. 国际神经病学神经外科学杂志, 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. 李长思, 马跃文. 生物刺激反馈仪治疗脊髓损伤所致神经源性膀胱的治疗效果. 中国医科大学学报, 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. 那彦群. 中国泌尿外科疾病诊断治疗指南手册. 北京: 人民卫生出版社, 2014.
27. Amarenco G, Sheikh Ismaël 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. 鲁功成, 曾甫清. 现代泌尿外科学. 武汉: 湖北科技出版社, 2003.
30. 陈忠, 崔喆, 双卫兵. 神经源性膀胱. 北京: 人民卫生出版社, 2009.
31. 楼洪刚, 刘芳, 翟所迪. 氨溴索雾化吸入治疗肺炎的系统评价. 中国循证医学杂志, 2006, 6(6): 421-429.
32. 李艳玲, 赵滨, 刘慧敏. 低分子肝素皮下注射持续时间对不良反应影响的Meta分析. 中国实用护理杂志, 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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