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과민성방광 환자에서 최대허용전기자극치료의 효과

Efficacy of Maximal Electrical Stimulationfor Treatment of Overactive Bladder

이규성|백상훈|최진호
대한배뇨장애요실금학회 (Korean Continence Society)|2007.06|International Neurourology Journal|제11권 제1호|pp. 47-53

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Abstract

Purpose: To evaluate the efficacy of acute maximal functional electrical stimulation (AMFES) for the treatment of overactive bladder (OAB). Materials and Methods: Twenty-eight patients (male 3, female 25) with OAB symptoms were treated with AMFES (10Hz biphasic alternating pulse, 20 min per session, 10 sessions) via intravaginal or anal electrode. They were divided into OAB symptoms with and without detrusor overactivity (DO) based on urodynamic study (n=15 vs. 13, respectively). DO-present group was subdivided into idiopathic DO subgroup (IDO, n=9) and neurogenic DO subgroup (NDO, n=6). The outcomes were assessed by 3-day frequency-volume chart and the Bristol Female Lower Urinary Tract Symptoms Questionnaire Changes in OAB symptoms at 1 and 3 months after discontinuing the stimulation were evaluated. Results: Cure rates for urgency and urge incontinence at 1-month after stimulation were determined as 62.5% and 50% in IDO group, 66.7% and 66.7% in NDO group, respectively, which were higher compared to DO-absent group. At 3-month after treatment most patients in IDO and DO-absent group who achieved a cure at 1 month, maintained improvement, however three (75%) of 4 patients in NDO group recurred. There were no significant changes in urodynamic parameters. The detrusor overactivity was no longer observed in 5 (55.6%) patients in IDO group and none in NDO group. Conclusion: AMFES has a beneficial effect on women with OAB. Our data suggest electrical stimulation may have a significant carry-over effect in well-selected OAB patients although further studies with large population are needed to establish long-term results. (J. Korean Continence Society 2007;11:47-53)

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