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Phys. Ther. Korea 2024; 31(2): 167-173

Published online August 20, 2024

https://doi.org/10.12674/ptk.2024.31.2.167

© Korean Research Society of Physical Therapy

Effect of Non-invasive Transcutaneous Electrical Stimulation in Women With Stress Urinary Incontinence: A Prospective Study

Ji-hyun Kim1 , PT, PhD, Hye-seon Jeon2 , PT, PhD, Oh-yun Kwon2 , PT, PhD, Ui-jae Hwang2 , PT, PhD, Eun Young Park3 , MD, PhD, Su-jin Kim4 , MD, PhD

1Department of Physical Therapy, The Graduate School, Yonsei University, 2Department of Physical Therapy, College of Health Sciences, Yonsei University, 3Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Wonju, 4Department of Urology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea

Correspondence to: Hye-seon Jeon
E-mail: hyeseonj@yonsei.ac.kr
https://orcid.org/0000-0003-3986-2030

Received: July 20, 2024; Revised: August 6, 2024; Accepted: August 6, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Stress urinary incontinence (SUI) impacts the social, physical, and psychological well-being and quality of life of the patient. Several techniques exist for its management, including transcutaneous electrical stimulation (TES).
Objects: We aimed to demonstrate the effects of TES on ultrasonographic variables and quality of life in women with SUI.
Methods: This prospective study recruited 21 women who had been diagnosed with grade 1 or 2 SUI between July 2018 and March 2019. The exclusion criteria were pregnancy and a history of urogenital surgery. All participants were assessed at baseline and 8 weeks after intervention initiation. The bladder neck position (BNP), length of the urethra (LU), funneling index (FI), and rhabdosphincter thickness (RT) were measured. The Incontinence-Quality of Life (I-QOL) was used to assess incontinence-specific quality of life. Statistical significance level was set at p < 0.05.
Results: Twenty-one patients with SUI used TES for 8 weeks. BNP and FI significantly decreased after intervention (p < 0.05). LU, anterior and posterior RT (indicators of external sphincter hypertrophy) significantly increased post-intervention (p < 0.05). The total I-QOL score increased from 64.81 to 71.86 after the intervention (p < 0.05).
Conclusion: This intervention improved BNP, LU, FI, RT, and subjective indicators such as quality of life in women with SUI. Therefore, TES can be an effective non-surgical treatment method for improving SUI symptoms and quality of life in these patients.

Keywords: Pelvic floor, Transcutaneous electric nerve stimulation, Urinary incontinence

Article

Original Article

Phys. Ther. Korea 2024; 31(2): 167-173

Published online August 20, 2024 https://doi.org/10.12674/ptk.2024.31.2.167

Copyright © Korean Research Society of Physical Therapy.

Effect of Non-invasive Transcutaneous Electrical Stimulation in Women With Stress Urinary Incontinence: A Prospective Study

Ji-hyun Kim1 , PT, PhD, Hye-seon Jeon2 , PT, PhD, Oh-yun Kwon2 , PT, PhD, Ui-jae Hwang2 , PT, PhD, Eun Young Park3 , MD, PhD, Su-jin Kim4 , MD, PhD

1Department of Physical Therapy, The Graduate School, Yonsei University, 2Department of Physical Therapy, College of Health Sciences, Yonsei University, 3Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Wonju, 4Department of Urology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea

Correspondence to:Hye-seon Jeon
E-mail: hyeseonj@yonsei.ac.kr
https://orcid.org/0000-0003-3986-2030

Received: July 20, 2024; Revised: August 6, 2024; Accepted: August 6, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Stress urinary incontinence (SUI) impacts the social, physical, and psychological well-being and quality of life of the patient. Several techniques exist for its management, including transcutaneous electrical stimulation (TES).
Objects: We aimed to demonstrate the effects of TES on ultrasonographic variables and quality of life in women with SUI.
Methods: This prospective study recruited 21 women who had been diagnosed with grade 1 or 2 SUI between July 2018 and March 2019. The exclusion criteria were pregnancy and a history of urogenital surgery. All participants were assessed at baseline and 8 weeks after intervention initiation. The bladder neck position (BNP), length of the urethra (LU), funneling index (FI), and rhabdosphincter thickness (RT) were measured. The Incontinence-Quality of Life (I-QOL) was used to assess incontinence-specific quality of life. Statistical significance level was set at p < 0.05.
Results: Twenty-one patients with SUI used TES for 8 weeks. BNP and FI significantly decreased after intervention (p < 0.05). LU, anterior and posterior RT (indicators of external sphincter hypertrophy) significantly increased post-intervention (p < 0.05). The total I-QOL score increased from 64.81 to 71.86 after the intervention (p < 0.05).
Conclusion: This intervention improved BNP, LU, FI, RT, and subjective indicators such as quality of life in women with SUI. Therefore, TES can be an effective non-surgical treatment method for improving SUI symptoms and quality of life in these patients.

Keywords: Pelvic floor, Transcutaneous electric nerve stimulation, Urinary incontinence

Fig 1.

Figure 1.Transcutaneous electrical stimulation device.
Physical Therapy Korea 2024; 31: 167-173https://doi.org/10.12674/ptk.2024.31.2.167

Fig 2.

Figure 2.Schematic of an ultrasonographic view; measurement of the bladder neck position.
Physical Therapy Korea 2024; 31: 167-173https://doi.org/10.12674/ptk.2024.31.2.167

Table 1 . Demographic characteristics of the participants.

CharacteristicTotal (N = 21)
Age (y)52.24 ± 8.11
Weight (kg)61.57 ± 8.89
Height (cm)159.00 ± 5.69
Body mass index (kg/m2)24.24 ± 3.21
Childbirth experience (n)18
Vaginal delivery (n)13
Menopausal status (n)13
Hormone drug therapy (n)0
Onset time (y)7.26

Values are presented as mean ± standard deviation or number only..


Table 2 . Ultrasonographic variables before and after the intervention (N = 21).

Before the interventionAfter the interventionp-value
BNP (°)24.38 ± 11.3216.38 ± 7.170.002*
LU (mm)22.88 ± 7.4027.43 ± 5.640.013*
FI (mm2)0.83 ± 0.450.54 ± 0.450.019*
ART (mm)2.40 ± 0.723.62 ± 1.230.002*
PRT (mm)2.16 ± 0.683.29 ± 0.840.001*

Values are presented as mean ± standard deviation. BNP, bladder neck position; LU, length of the urethra; FI, funneling index; ART, anterior rhabdosphincter thickness; PRT, posterior rhabdosphincter thickness. *p < 0.05..