| Institution: | 1. Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan;2. School of Medicine, National Yang-Ming University, Taipei, Taiwan;3. Department of Emergency, Mackay Memorial Hospital, Taipei, Taiwan;4. Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan;5. Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan;1. Obstetrics and Gynecology Unit, Department of Obstetrics, Gynecology and Pediatrics, Azienda Ospedaliera “Santa Maria Nuova,” Istituto di Ricovero e Cura a Carattere Scientifico, University of Modena and Reggio Emilia, Reggio Emilia, Italy;2. Departments of Obstetrics and Gynecology, University “Magna Graecia” of Catanzaro, Catanzaro, Italy;3. Departments of Obstetrics and Gynecology, Second University of Naples, Naples, Italy;4. Unit of Obstetrics and Gynecology, Hospital “Civico” of Palermo, Palermo, Italy;5. Department of Obstetrics and Gynecology, University “Federico II” of Naples, Naples, Italy;6. Department of Obstetrics and Gynecology, University of Molise, Molise, Italy;1. University of Aberdeen, Aberdeen, Scotland, United Kingdom;2. Ayrshire & Arran National Health Services, Scotland, United Kingdom;3. Borders National Health Services Board, Melrose, Scotland, United Kingdom;4. Greater Glasgow & Clyde Health Board, Glasgow, Scotland, United Kingdom;5. National Health Services, Fife, Scotland, United Kingdom;6. Lanarkshire National Health Services, Scotland, United Kingdom;1. Abertawe Bro Morgannwg University Health Board, Swansea, United Kingdom;2. Swansea University, Swansea, United Kingdom;1. Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan;2. Pfizer Japan Inc, Tokyo, Japan;1. University of Toronto, Toronto, Ontario, Canada;2. University Hospital of the Canary Islands, Spain;3. Seattle Urology Research Center, Burien, WA;4. Hospital Clinic I Provincial, Barcelona, Spain;5. Florida International University, Miami, FL;6. Astellas Pharma Europe B.V. Leiden, The Netherlands;7. Astellas Pharma Global Development, Northbrook, IL;8. Maastricht University Medical Center, Maastricht, The Netherlands |
| Abstract: | ObjectiveTo evaluate the effects of sacral magnetic stimulation (SMS) on functional and urodynamic improvement in patients with refractory stress urinary incontinence (SUI).DesignA sham-controlled, double-blind, parallel study design with a 4.5-month follow-up.SettingA tertiary hospital.ParticipantsWomen (age, 45–75y) with SUI refractory to first-line management (N=34) were allocated to either an experimental (n=20) group or a sham (n=14) group.InterventionsThe SMS protocol consisted of 5-Hz, 20-minute treatments administered over the bilateral third sacral roots, with the intensity set at approximately 70% of the maximal output, for 12 consecutive weekdays.Main Outcome MeasuresUrodynamic assessments and 2 life stress questionnaires, namely, the Urge-Urinary Distress Inventory (U-UDI) and the Overactive Bladder Questionnaire (OAB-q), were administered pre- and post-SMS intervention. We administered the U-UDI (primary outcome measure) and the OAB-q at 3-week intervals during the follow-up period until 18 weeks after the final intervention.ResultsThe experimental group exhibited significant improvements in both U-UDI and OAB-q scores postintervention (P=.011–.014) and at follow-up visits (P<.001–.007) compared with the sham group. In addition, significant increases in bladder capacity, urethral functional length, and the pressure transmission ratio (P=.009–.033) were noted postintervention. Multivariate regression analysis revealed that patients with more severe symptoms benefited more from SMS. A poorer baseline U-UDI score and a shorter urethral functional length were associated with a greater response to SMS.ConclusionsOur observations of a greater response to SMS in patients with more severe SUI than in those with mild symptoms, as well as the long-term benefits of the treatment, confirm the efficacy of SMS in treating SUI. |
