Extracorporeal Electromagnetic Stimulation for Overactive Bladder Patients with Urinary Incontinence: A Single Institute Experience

膀胱過動症患者合併尿失禁病人施行體外電慈刺激：單一機構之研究經驗分享

林佑樺(Yu-Hua Lin) ； 黃旭澤(Hsu-Che Huang) ； 姜秉均(Bing-Juin Chiang) ； 王敏慧(Min-Hui Wang) ； 廖俊厚(Chun-Hou Liao)

《輔仁醫學期刊》 16卷2期 (2018/06) Pp. 57-65

https://doi.org/10.3966/181020932018061602001

摘要

Background and purpose: Overactive bladder (OAB) is a syndrome characterized by urgency and frequency, with or without urge incontinence. Extracorporeal electromagnetic stimulation (EMS) has been successfully applied for the treatment of stress and urinary urge incontinence. We report our experience of using extracorporeal electromagnetic stimulation for patients with OAB and urinary incontinence, and investigate predictors for successful treatment. Methods: Between 2009 and 2016, 162 patients (88 women and 74 men), who presented with OAB symptoms and urinary incontinence treated with EMS treatment, were enrolled in this study. Treatment results were assessed by global response assessment. The overactive bladder symptom score (OAB-SS) questionnaire was recorded before and after treatment. Logistic regression analysis was used to identify predictors for an improved outcome. Results: All patients tolerated the treatment without any adverse event and mean age was 66.9 ± 13.8 years. In total, 103 patients (63.6%) reported improved outcomes (GRA ≧ 1). The mean total OABSS score decreased significantly after treatment (10.4 ± 3.1 versus 6.1 ± 3.5, p ＜ 0.01). Pure stress urinary incontinence patients showed less improvement when compared to patients with mixed urinary incontinence or pure urgency urinary incontinence. Male patients without a previous history of transurethral resection of prostate history (odds ratio = 3.17, p=0.03) could serve as predictors of a satisfactory outcome. Conclusions: Treatment course involving EMS of the pelvic floor can improve the symptoms of most OAB patients with synchronous incontinence symptoms. EMS could therefore be considered as an alternative treatment for patients with OAB.

關鍵字

Extracorporeal electromagnetic stimulation ； overactive bladder ； urinary incontinence

並列摘要

研究目的：膀胱過動症為一表現急尿與頻尿之症候群病人且可能合併急迫性尿失禁。體外電磁刺激在過去便已知為應力性尿失禁及急迫性尿失禁之成功治療選擇，但卻不清楚對於膀胱過動症的影響是否也能夠改善，本研究為單一機構在合併性尿失禁的膀胱過動症病患的治療經驗，並且從中尋找可能的治療預測因子。研究方法：自2009 至2016 年，共162 位膀胱過動症合併急迫性尿失禁病患（其中為88 位女性及74位男性）接受體外電磁刺激治療，本研究透過個問卷量表評估階段性治療後在整體及膀胱過動情況是否有改善。結果：所有病患均沒有副作用且完成階段治療，其中平均年齡為66.9 歲，63.6% 的病患表達獲得改善的情況，在膀胱過動症合併尿失禁的病人族群中，若其尿失禁類型為單純應力性尿失禁患者相對於急迫性尿失禁與混和性尿失禁患者的改善幅度較小，另外男性病患且之前未曾接受過攝護腺手術者也較有良好的預後（OR: 3.17, p=0.03）. 結論：體外電磁刺激在同時合併尿失禁的膀胱過動症患者仍為一有效的治療方式，因此更甚至可考慮作為膀胱過動症患者的治療選項。

並列關鍵字

體外電磁刺激 ； 膀胱過動症 ； 尿失禁