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Neuromodulation for the treatment of urinary incontinence
Author(s) -
Yamanishi Tomonori,
Kamai Takao,
Yoshida KenIchiro
Publication year - 2008
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2008.02080.x
Subject(s) - medicine , neuromodulation , urinary incontinence , pelvic floor , sacral nerve stimulation , placebo , urology , randomized controlled trial , stress incontinence , stimulation , surgery , alternative medicine , pathology
Neuromodulation has been reported to be effective for the treatment of stress and urgency urinary incontinence. The cure and improvement rates of pelvic floor neuromodulation in urinary incontinence are 30–50% and 60–90%, respectively. In clinical practice, vaginal, anal and surface electrodes are used for external, short‐term stimulation, and sacral nerve stimulation for internal, chronic (long‐term) stimulation. The effectiveness of neuromodulation has been verified in a randomized, placebo‐controlled study. However, the superiority to other conservative treatments, such as pelvic floor muscle training has not been confirmed. A long‐term effect has also been reported. In conclusion, pelvic floor exercise with adjunctive neuromodulation is the mainstay of conservative management for the treatment of stress incontinence. For urgency and mixed stress plus urgency incontinence, neuromodulation may therefore be the treatment of choice as an alternative to drug therapy.