Comparison of effects of intravaginal electrostimulation and surface electrostimulation in women with stress urinary incontinence

Abstract

The urinary incontinence (UI) occurs in more of 200 millions of the people in the world and the stress urinary incontinence (SUI) is the most common type of UI. The physiotherapeutic treatment has promising results and one of the treatments is the electrical stimulations (ES) that can be performed with intravaginal or surface electrode in women that not perform the correct pelvic floor muscle contraction. But, it had not recent studies that evaluated the effect of the surface electrical stimulation, so in the clinical practice the intravaginal electrical stimulation is more used in SUI treatment. Therefore, the objective of this study is going to be to compare the effects of the intravaginal electrical stimulation and surface electrical stimulation to the SUI treatment in women. This is a prospective, randomized and blind study. The study is going to include 45 women aged over 50 years, with diagnostic of SUI in the clinical exam and that never performed physical therapy to UI. The exclusion criteria of this study is going to be: pelvic organ prolapse greater than grade II on Baden-Walker classification system, vaginal or urinary infections, use of pacemaker implantation or metal rods in pelvic or femur, radiotherapy, pregnancy, previous treatment or surgery for SUI, cognitive or neurological disorder. The voluntaries will perform four evaluations during the study: initial evaluation, evaluation of the sixth treatment session, final evaluation and 12 sessions after the treatment. In the evaluations it is going be performed the evaluation form, King´s Health Questionnaire, pelvic floor muscle electromyography, one-hour pad test, perineometry and transperineal ultrasound. After the initial evaluation the voluntaries are going to be randomized in three groups by raffle of envelopes: intravaginal electrical stimulation group (IVESG), surface electrical stimulation group (SESG) and control group (CG). In the IVESG and SESG the treatment will be of 12 sessions, twice a week, with Dualpex 961 equipment and the parameter that will used: frequency: 50Hz; pulse width: 700µs; on-off cycle: 4 to 8 seconds; stimulation intensity: maximal level tolerable and time of 20 minutes. The statistical analysis is going to be performed using nonparametric Friedman test, Kruskal-Wallis, Spearman, Chi-Square and will be used a significance level of 5%. (AU)