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Bele U, Serdinšek T, Homšak E, But I. The Impact of Extracorporeal Magnetic Stimulation as Addition to Mirabegron in Overactive Bladder Treatment in Women: A Single-Centre Randomized Sham-Controlled Study. J Clin Med 2024; 13:916. [PMID: 38337609 PMCID: PMC10856599 DOI: 10.3390/jcm13030916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: The purpose of our prospective, single-blinded, randomized, sham-controlled study was to investigate the effect of the additional extracorporeal magnetic stimulation (ExMI) to pharmacological treatment in overactive bladder syndrome (OAB) in women. (2) Methods: We recruited 56 women with OAB, who were allocated into two study groups: the active group received mirabegron 50 mg daily and a total of 16 sessions of ExMI in 8 weeks, whereas the sham group received mirabegron 50 mg daily and sham stimulation following the same treatment protocol. Treatment success was evaluated after 4 and 8 weeks. (3) Results: Both groups experienced significant reduction in daytime urinary frequency, nocturia, and number of weekly incontinence episodes after 8 weeks. There were no statistically significant differences in end-point daytime urinary frequency and nocturia between groups. However, the overall average reduction rate in weekly number of incontinence episodes was 43.7% in treatment group and 24.2% in the control group. The number of urinary incontinence episodes in the treatment and control group was reduced for 3.8 ± 11.8 vs. 2.5 ± 4.3 episodes at week 4 and additional 3.3 ± 6 vs. 0.4 ± 3.2 episodes at week 8, respectively (p = 0.013). Moreover, IIQ-7 score showed a significantly greater score reduction and patients' evaluated improvement of symptoms was higher in the active group. (4) Conclusions: The addition of ExMI to mirabegron in OAB treatment further improves the weekly incontinence episode reduction rate and also leads to grater improvement in symptoms.
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Affiliation(s)
- Uros Bele
- Medical Faculty, University of Maribor, 2000 Maribor, Slovenia; (U.B.); (I.B.)
- Department for Urology, University Hospital Graz, 8036 Graz, Austria
| | - Tamara Serdinšek
- Medical Faculty, University of Maribor, 2000 Maribor, Slovenia; (U.B.); (I.B.)
- Department of General Gynaecology and Gynaecologic Urology, Clinic for Gynecology and Perinatology, University Medical Centre Maribor, 2000 Maribor, Slovenia
| | - Evgenija Homšak
- Medical Faculty, University of Maribor, 2000 Maribor, Slovenia; (U.B.); (I.B.)
- Department of Laboratory Diagnostics, University Medical Centre Maribor, 2000 Maribor, Slovenia
| | - Igor But
- Medical Faculty, University of Maribor, 2000 Maribor, Slovenia; (U.B.); (I.B.)
- Department of General Gynaecology and Gynaecologic Urology, Clinic for Gynecology and Perinatology, University Medical Centre Maribor, 2000 Maribor, Slovenia
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Antić A, Pavčnik M, Lukanović A, Matjašič M, Lukanović D. Magnetic stimulation in the treatment of female urgency urinary incontinence: a systematic review. Int Urogynecol J 2023; 34:1669-1676. [PMID: 36877276 PMCID: PMC10415412 DOI: 10.1007/s00192-023-05492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/08/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION AND HYPOTHESIS This systematic review analyzes published studies about magnetic stimulation (MS) treatment for UUI and determines whether this treatment is effective and non-invasive. METHODS A systematic literature search was conducted using PubMed, the Cochrane Library, and Embase. The international standard for reporting results of systematic reviews and meta-analyses (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to guide the methodology of this systematic review. The key search terms were as follows: "magnetic stimulation" and "urinary incontinence." We limited the time frame to articles published from 1998, when the FDA approved MS as a conservative treatment option for UI. The last search was performed on 5 August 2022. RESULTS Two authors independently reviewed 234 article titles and abstracts, of which only 5 fitted the inclusion criteria. All 5 studies included women with UUI, but every study had different diagnostic and entry criteria for patients. They also differed in their treatment regimens and methodological approaches to assessing the efficacy of treating UUI with MS, which made it impossible to compare the results. Nonetheless, all five studies established that MS is an effective and non-invasive way of treating UUI. CONCLUSIONS The systematic literature review led to the conclusion that MS is an effective and conservative way of treating UUI. Despite this, literature in this area is lacking. Further randomized controlled trials are needed, with standardized entry criteria, UUI diagnostics, MS programs, and standardized protocols to measure the efficacy of MS in UUI treatment, with a longer follow-up period for post-treatment patients.
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Affiliation(s)
- Anja Antić
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Pavčnik
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Adolf Lukanović
- Division of Gynecology and Obstetrics, Ljubljana University Medical Center, Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miha Matjašič
- Department of Education Studies, Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
| | - David Lukanović
- Division of Gynecology and Obstetrics, Ljubljana University Medical Center, Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Pavčnik M, Antić A, Lukanović A, Krpan Ž, Lukanović D. Evaluation of Possible Side Effects in the Treatment of Urinary Incontinence with Magnetic Stimulation. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1286. [PMID: 37512097 PMCID: PMC10383588 DOI: 10.3390/medicina59071286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Magnetic stimulation is a type of conservative treatment of urinary incontinence. Our aim was to evaluate the possible side effects of this method. Materials and Methods: We conducted a systematic literature review. The key search terms were urinary incontinence, magnetic stimulation, and female. All known synonyms were used. Results: 255 titles and abstracts were retrieved, and 28 articles met our inclusion criteria. Out of 28 studies, 15 reported no side effects, five reported side effects, and eight did not report anything. There was no significant difference in the incidence of side effects between the sham and active treatment groups. Conclusions: Side effects of magnetic stimulation in comparison to other active treatments are minimal and transient. Among the conservative UI treatment methods, magnetic stimulation is one of the safest methods for the patient and as such a suitable first step in treating UI.
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Affiliation(s)
- Maja Pavčnik
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Anja Antić
- Ljubljana University Medical Center, 1000 Ljubljana, Slovenia
| | - Adolf Lukanović
- Division of Gynecology and Obstetrics, Ljubljana University Medical Center, 1000 Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Žan Krpan
- Independent Researcher, Zanzna s.p., 1000 Ljubljana, Slovenia
| | - David Lukanović
- Division of Gynecology and Obstetrics, Ljubljana University Medical Center, 1000 Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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Dudonienė V, Kirklytė I, Žlibinaitė L, Jerez-Roig J, Rutkauskaitė R. Pelvic Floor Muscle Training versus Functional Magnetic Stimulation for Stress Urinary Incontinence in Women: A Randomized Controlled Trial. J Clin Med 2023; 12:jcm12093157. [PMID: 37176598 PMCID: PMC10179444 DOI: 10.3390/jcm12093157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND There is strong evidence that specific pelvic floor muscle training (PFMT) reduces stress urinary incontinence (SUI), but the application of functional magnetic stimulation (FMS) is still under discussion. OBJECTIVE To evaluate and compare the effects of FMS and PFMT on pelvic floor muscle function, urinary incontinence symptoms and quality of life (QoL) in women with SUI. METHODS A randomized controlled, parallel-group trial was executed in an outpatient physical medicine and rehabilitation centre. The study included 68 women and was fully completed by 48 women (n = 24 in each group) aged 29-49 years, with SUI, who were randomly assigned to PFMT and FMS groups. The symptoms of urinary incontinence and their impact on quality of life were assessed with two questionnaires: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the Incontinence Impact Questionnaire-Short Form (IIQ-7). Perineometer (Pelvexiser) was used to measure the resting vaginal pressure, pelvic floor muscle (PFM) strength and endurance. All outcome measures were taken at baseline and after 6 weeks of interventions. Cohen's effect size (d) was calculated. RESULTS A significant improvement (p < 0.05) of ICIQ-SF and IIQ-7 was observed in both groups with a high effect size in the PFMT group (d = 1.56 and d = 1.17, respectively) and the FMS group (d = 1.33 and d = 1.45, respectively). ICIQ-SF and IIQ-7 scores did not differ significantly between groups after the 6-week treatment period. Resting vaginal pressure, PFM strength and endurance increased (p < 0.05) in both groups with a medium (d = 0.52) to large (d = 1.56) effect size. CONCLUSION No significant difference between groups was found in any measurement of perineometry. PFMT and FMS significantly improved SUI symptoms and the quality of life of the study participants. None of the applied interventions was superior to the other in the short-term effect.
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Affiliation(s)
- Vilma Dudonienė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
| | - Indrė Kirklytė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
| | - Laura Žlibinaitė
- Department of Rehabilitation, Kauno Kolegija Higher Education Institution, Muitines 15, LT-44280 Kaunas, Lithuania
| | - Javier Jerez-Roig
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Renata Rutkauskaitė
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
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Lee YS, Khan AA. Financial Toxicity for Female Patients with Urinary Incontinence. Curr Urol Rep 2023; 24:33-39. [PMID: 36527587 DOI: 10.1007/s11934-022-01130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Urinary incontinence (UI) is a common global condition that has been noted to disproportionately affect women. In this review, the authors present discussion of factors contributing to cost of care and various modalities of cost-effective care for UI for female patients. RECENT FINDINGS We found insurance and out-of-pocket (OOP) costs strongly impact of costs for patients. Further, in evaluation of UI, diagnosis can be a costly multi-step process for effective treatment. Treatment can be multimodal, including non-surgical (e.g., pessary, vaginal insert, pelvic floor muscle training, or PFMT), of which PFMT is a cost-effective, effective, and accessible treatment. Pharmacologic management is generally second-line for overactive bladder, but anti-muscarinic drugs and beta-3 agonists are cost-effective depending on willingness-to-pay and the health system in which they are acquired, respectively. Surgical management is considered the most cost-effective treatment as willingness-to-pay increased, with minimally invasive slings being the mainstay. Other relatively novel treatments are also discussed (e.g., EMSELLA) but require further research. Additionally, we discuss systematic barriers in decisions to seek care for urinary incontinence. Urologists are key agents in treating UI for their female patients, and seeking cost-effective options for treatment remains pivotal for quality care.
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Affiliation(s)
- Yeonsoo S Lee
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Aqsa A Khan
- Department of Urology, Mayo Clinic, Phoenix, AZ, USA.
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Pulsed Magnetic Stimulation for Stress Urinary Incontinence and Its Impact on Sexuality and Health. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121721. [PMID: 36556922 PMCID: PMC9784697 DOI: 10.3390/medicina58121721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
It is becoming increasingly common that patients' preferences move towards non-surgical approaches, such as pulsed magnetic stimulation, for female stress urinary incontinence. OBJECTIVE We evaluated the efficacy and safety of a device that uses electromagnetic technology to treat urinary incontinence, with an emphasis on health-related quality of life. METHODS A total of 47 female subjects from 18 to 80 years old were enrolled. After block randomization, treatment consisted of 2 pulsed planar magnetic stimulation sessions per week for 4 weeks (8 sessions). Validated questionnaires: Female Sexual Function Index, International Consultation on Incontinence Questionnaire for Urinary Incontinence: Short Form, and Pelvic Floor Bothersome. Follow-ups were performed at weeks 1, 9, and 14. RESULTS The present study is one of the first clinical trials published evaluating the efficacy and safety of the electromagnetism-based device with flat configuration in patients with stress urinary incontinence, showing a reduction in PFBQ, ICQSF, and Oxford test scores during follow-up, and significantly at week 14 of follow-up, which implied a favorable impact on clinical outcomes, quality of life, and sexuality. CONCLUSIONS The improved results in the treatment group compared with the simulated group show that pulsed magnetic stimulation is a safe and attractive non-invasive alternative for patients who prefer non-surgical treatments.
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Tezer T, Yıldız N, Sarsan A, Alkan H. Short-term effect of magnetic stimulation added to bladder training in women with idiopathic overactive bladder: A prospective randomized controlled trial. Neurourol Urodyn 2022; 41:1380-1389. [PMID: 35593007 DOI: 10.1002/nau.24957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/16/2022] [Accepted: 05/10/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the efficacy of magnetic stimulation (MStim) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). MATERIAL AND METHODS Seventy-six women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n: 38), and Group 2 received BT + MStim (n: 38). MStim was performed with MStim therapy armchair (Novamag NT60), 2 days a week, 20 min a day, a total of 12 sessions for 6 weeks. Women were evaluated in terms of incontinence severity (24-h pad test), 3-day voiding diary (frequency of voiding, incontinence episodes, nocturia, and number of pads), symptom severity (OAB-V8), QoL (IIQ-7), positive response and cure-improvement rates, and treatment satisfaction (Likert scale) at the baseline and the end of treatment (sixth week). RESULTS A statistically significant improvement was found in incontinence severity, frequency of voiding, incontinence episodes, nocturia, number of pads, symptom severity, and QoL parameters for two groups at the end of the treatment compared to the baseline values (p < 0.05). At the end of treatment; incontinence severity, incontinence episodes, nocturia, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p < 0.05). No difference was found between the two groups in terms of frequency of voiding (p > 0.05). The positive response and cure-improvement rates, and treatment satisfaction were significantly higher in Group 2 than in Group 1 (p < 0.05). CONCLUSION MStim added to BT is more effective than BT alone in women with idiopathic OAB.
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Affiliation(s)
- Tevfik Tezer
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Necmettin Yıldız
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Ayşe Sarsan
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Hakan Alkan
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey
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Efficacy of Magnetic Therapy in Pain Reduction in Patients with Chronic Pelvic Pain: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105824. [PMID: 35627359 PMCID: PMC9141928 DOI: 10.3390/ijerph19105824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/30/2022] [Accepted: 05/06/2022] [Indexed: 12/03/2022]
Abstract
Chronic pelvic pain (CPP), also known as chronic pelvic pain syndrome (CPPS), is a common and painful condition. However, its treatment is still a challenge. The findings about the beneficial effects of electromagnetic therapy provide a new, potentially valid, therapeutic alternative for the management of patients with CPP. Objectives: to analyze the efficacy of magnetic field therapy in pain reduction in patients with CPP and for other variables, such as urinary symptoms and quality of life, as well as to review the evidence, in order to establish an action protocol. A qualitative systematic review was carried out, based on the PRISMA protocol and registered in PROSPERO (CRD42022285428). A search was performed in the PubMed, Medline, Scopus, Cochrane, PEDro, BVS, and WOS databases, including those articles in which the patients suffered from CPP; the study variable was pain, and the intervention was based on the application of magnetic fields. Results: Among the 81 articles found, five clinical trials were considered (with an average score of 7.2 in the PEDro scale), with a total of 278 participants, most of whom presented improvements in perceived pain (p ≤ 0.05), as well as in quality of life (p < 0.05) and urinary symptoms (p = 0.05), evaluated through the NIH-CPSI and VAS scales. The therapy was conducted as a monotherapy or in combination with a pharmacological treatment. There was no common protocol among the different articles. Conclusions: Intervention programs through electromagnetic therapy, on their own or with other therapies, can be effective in patients with CPP.
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Lopopolo G, Salsi B, Banfi A, Isaza PG, Fusco I. Is It Possible to Improve Urinary Incontinence and Quality of Life in Female Patients? A Clinical Evaluation of the Efficacy of Top Flat Magnetic Stimulation Technology. Bioengineering (Basel) 2022; 9:bioengineering9040140. [PMID: 35447699 PMCID: PMC9032201 DOI: 10.3390/bioengineering9040140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Urinary incontinence is the accidental loss of urine that can occur at any age, especially among women over 50; however, its prevalence is increasing. This study aimed to assess the efficacy and safety of a device that uses Top Flat Magnetic Stimulation for the management of women with mixed urinary incontinence. Materials and Methods: A total of 50 female patients underwent a total of six treatment sessions performed twice a week for three consecutive weeks, for 28 min. Three questionnaires were used for the evaluation of the urinary improvements: Urinary Incontinence Short Form (ICIQ-UI-SF), Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB), and Incontinence Impact Questionnaire-Short Form (IIQ-7). The questionnaires were compiled immediately before each treatment, within the treatment period (until the sixth treatment session), and up to 3 months of follow-up. Results: Improvement in quality of life is observed according to the results of the questionnaire, already after six sessions and at three months follow-up. ICIQ-UI-SF’s average score at baseline was 20.2 (±1.1), and it significantly declined (p < 0.01) to 1.8 (±2.4) after six sessions and to 4.8 (±2.8) at 3 months follow-up; ICIQ-OAB’s average score significantly decreased (p < 0.01) from 10.4 (±3.2) at baseline to 1.4 (±0.8) after six sessions and 2.3 (±1.6) at 3 months follow-up. IIQ-7’s average score significantly decreased (p < 0.01) from 20.2 (±1.7) at baseline to 0.4 (±0.5) after six sessions and to 4.7 (±2.8) at 3 months follow-up. Conclusions: Our results suggest that Top Flat Magnetic Stimulation technology can reduce mixed urinary incontinence symptoms for all women examined, leading to an improvement in the patient quality of life and patient awareness of their pelvic floor area with good results.
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Affiliation(s)
- Graziella Lopopolo
- Division of Gynecology, Poliambulatorio San Michele, 42121 Reggio Emilia, Italy; (G.L.); (A.B.)
| | - Benedetta Salsi
- Division of Dermatology, Poliambulatorio San Michele, 42121 Reggio Emilia, Italy;
| | - Alessandra Banfi
- Division of Gynecology, Poliambulatorio San Michele, 42121 Reggio Emilia, Italy; (G.L.); (A.B.)
| | - Pablo González Isaza
- Functional and Regenerative Gynecology DIATROS, Clínica d’ Atenció a la Dona, 08022 Barcelona, Spain;
| | - Irene Fusco
- Department of Pharmacology, University of Florence, 50121 Florence, Italy
- Correspondence: ; Tel.: +39-3286853105
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Basnet S, Magee CL. Technological Improvement Rates and Evolution of Energy-Based Therapeutics. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 3:714140. [PMID: 35047947 PMCID: PMC8757806 DOI: 10.3389/fmedt.2021.714140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
This paper examines the field of energy-based medical therapies based on the analysis of patents. We define the field as the use of external stimuli to achieve biomedical modifications to treat disease and to increase health. Based upon distinct sets of patents, the field is subdivided into sub-domains for each energy category used to achieve the stimulation: electrical, magnetic, microwave, ultrasound, and optical. Previously developed techniques are used to retrieve the relevant patents for each of the stimulation modes and to determine main paths along the trajectory followed by each sub-domain. The patent sets are analyzed to determine key assignees, number of patents, and dates of emergence of the sub-domains. The sub-domains are found to be largely independent as to patent assignees. Electrical and magnetic stimulation patents emerged earliest in the 1970s and microwave most recently around 1990. The annual rate of improvement of all sub-domains (12-85%) is found to be significantly higher than one we find for an aggregate pharmaceutical domain (5%). Overall, the results suggest an increasingly important role for energy-based therapies in the future of medicine.
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Affiliation(s)
- Subarna Basnet
- SUTD-MIT International Design Center, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Christopher L Magee
- SUTD-MIT International Design Center, Massachusetts Institute of Technology, Cambridge, MA, United States.,Massachusetts Institute of Technology (MIT) Institute for Data, Systems and Society (IDSS), Cambridge, MA, United States
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Hou WH, Lin PC, Lee PH, Wu JC, Tai TE, Chen SR. Effects of extracorporeal magnetic stimulation on urinary incontinence: A systematic review and meta-analysis. J Adv Nurs 2020; 76:2286-2298. [PMID: 32538469 DOI: 10.1111/jan.14450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/06/2020] [Accepted: 05/15/2020] [Indexed: 11/28/2022]
Abstract
AIMS To examine the effectiveness of extracorporeal magnetic stimulation for treatment of stress urinary incontinence. DESIGN Systematic review and meta-analysis. DATA RESOURCES Four electronic databases from inception to 18 May 2019. REVIEW METHODS Two authors independently performed the search, assessed the methodological quality, and extracted data. The final studies included in the analysis were selected after reaching consensus with the third author. RESULTS A total of 20 studies were included in the systematic review and 12 of these in the meta-analysis. Quality assessment indicated that only 8 of 17 randomized controlled trials had low risk in overall risk of bias, whereas all controlled trials had serious risk of bias. The weighted mean effect size of magnetic stimulation on quality of life, number of leakages, pad test outcomes, and number of incontinence events was 1.045 (95% CI: 0.409-1.681), -0.411 (95% CI: 0.178-0.643), -0.290 (95% CI: 0.025-0.556), and -0.747 (95% CI: -1.122 to -0.372), respectively. Subgroup analysis revealed a significant difference in the type of quality of life measurement used. Sensitivity analyses revealed that a high degree of heterogeneity persisted even after omitting studies individually. CONCLUSIONS Extracorporeal magnetic stimulation may be effective in treating urinary incontinence and improving quality of life without major safety concerns. However, because of a high degree of heterogeneity among studies, inferences from the results must be made with caution. IMPACT We recommend that clinical nurses apply extracorporeal magnetic stimulation to treat stress urinary incontinence among female patients and encourage researchers to conduct further qualitative and quantitative studies to develop consistent content and dosage for the intervention. STUDY REGISTRATION The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.york.ac.uk/Prospero with the registration number #CRD42019138835).
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Affiliation(s)
- Wen-Hsuan Hou
- Department of Physical Medicine & Rehabilitation, Center of Evidence-based Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Master Program in Long-Term Care, College of Nursing, Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Pi-Chu Lin
- Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Jeng-Cheng Wu
- Department of Urology, Department of Education, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ting-En Tai
- Department of Urology, Center of Evidence-based Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Su-Ru Chen
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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12
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Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy. J Clin Med 2020; 9:jcm9041211. [PMID: 32340194 PMCID: PMC7230757 DOI: 10.3390/jcm9041211] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022] Open
Abstract
Urinary incontinence (UI) is a common health problem affecting quality of life of nearly 420 million people, both women and men. Pelvic floor muscle (PFM) training and other physiotherapy techniques play an important role in non-surgical UI treatment, but their therapeutic effectiveness is limited to slight or moderate severity of UI. Higher UI severity requires surgical procedures with pre- and post-operative physiotherapy. Given that nearly 30%–40% of women without dysfunction and about 70% with pelvic floor dysfunction are unable to perform a correct PFM contraction, therefore, it is particularly important to implement physiotherapeutic techniques aimed at early activation of PFM. Presently, UI physiotherapy focuses primarily on PFM therapy and its proper cooperation with synergistic muscles, the respiratory diaphragm, and correction of improper everyday habits for better pelvic organ support and continence. The purpose of this work is a systematic review showing the possibilities of using physiotherapeutic techniques in the treatment of UI in women with attention to the techniques of PFM activation. Evidence of the effectiveness of well-known (e.g., PFM training, biofeedback, and electrostimulation) and less-known (e.g., magnetostimulation, vibration training) techniques will be presented here regarding the treatment of symptoms of urinary incontinence in women.
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Yamashiro J, de Riese W, de Riese C. New Implantable Tibial Nerve Stimulation Devices: Review of Published Clinical Results in Comparison to Established Neuromodulation Devices. Res Rep Urol 2019; 11:351-357. [PMID: 31921712 PMCID: PMC6934123 DOI: 10.2147/rru.s231954] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 11/26/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this review is to offer an update for medical providers practicing general urology and urogynecology in evolving and new promising technologies for neuromodulation in patients with OAB. Patients and Methods A focused literature search for the years 2015 through 2019 was conducted on PubMed/Medline for the terms: “new techniques” AND “neuromodulation” AND “tibial nerve stimulation” AND “overactive bladder”. We limited our search to publications in English, for the last five years and with patient follow-up of at least 3 months. Results Clinical success, safety based on adverse events, and quality of life improvement criteria were evaluated and compared to sacral nerve stimulation (SNS) devices and older, non-implantable percutaneous tibial nerve stimulation (PTNS) treatment devices. Considering the limited number of participants with up to 6 months follow-up data currently available, overall the clinical response rates suggest that the new implantable devices stimulating the tibial nerve have a promising clinical outlook, are less invasive upon implantation than SNS, less expensive, and less of a burden on patients compared to the older non-implantable PTNS devices. Conclusion Practicing urologists should be aware of this new treatment option when counseling their patients regarding treatment for OAB.
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Affiliation(s)
- Justine Yamashiro
- School of Medicine, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Werner de Riese
- Department of Urology, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Cornelia de Riese
- Department of Obstetrics and Gynecology, Texas Tech University Health Science Center, Lubbock, TX, USA
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