ABSTRACT
OBJETIVO: Principal, evaluar la eficacia de la electroestimulación percutánea del tibial posterior (P-PTNS) en incontinencia urinaria de urgencia (IUU) e incontinencia fecal (IF) refractarias al tratamiento de primera línea. Secundario, determinar factores predictores de respuesta al tratamiento. Estudio analítico longitudinal prospectivo de 2 años de duración en pacientes con IUU e IF tratados con P-PTNS. MATERIAL Y MÉTODO: Pacientes con IUU e IF tratados con P-PTNS y que responden al diario miccional/defecatorio, cuestionarios de severidad y calidad de vida. Se excluyen pacientes con IUU neurogénica, que abandonan el tratamiento o no responden a los cuestionarios. Variables demográficas, clínicas (hábito miccional/defecatorio pre- y postratamiento), escalas de severidad pre- y postratamiento (ICIQ-SF, Sandvick y Wexner), mejoría subjetiva y calidad de vida (IQOL y FIQL pre- y postratamiento). Análisis estadístico con SPSS v19. RESULTADOS: Muestra de 21 pacientes en dos grupos: -Grupo IUU, 9 pacientes. Tras P-PTNS mejoría estadísticamente significativa de frecuencia miccional diurna (p = 0,018) y nocturna (p = 0,016), urgencias/día (p = 0,018), pérdidas/día (p = 0,027), ICIQ-SF y Sandvick (p = 0,018), y calidad de vida IQOL (p = 0,012). Esta mejoría se relaciona con el ejercicio (p = 0,039) y prolapso (p = 0,05). -Grupo IF, 12 pacientes. Tras P-PTNS mejoría estadísticamente significativa de frecuencia defecatoria (p = 0,027), incontinencia (p = 0,012), Wexner (p = 0,007), y FIQL en sus 4 dimensiones (estilo de vida, conducta, vergüenza p = 0,005; y depresión p = 0,008). Esta mejoría se relaciona con edad (p = 0,048), tiempo de evolución (p = 0,044) y prolapso (p = 0,026). CONCLUSIONES: La P-PTNS es eficaz en IUU e IF refractarias al tratamiento convencional; la respuesta al tratamiento está influenciada por distintos factores
OBJECTIVE: The main aim of this study was to assess the efficacy of percutaneous posterior tibial nerve electrostimulation (P-PTNS) in urge urinary incontinence (UUI) and faecal incontinence (FI) refractory to first-line treatment. A secondary aim was to identify predictors of treatment response. To do this, we performed a 2-year analytical, longitudinal and prospective study in patients with UUI and FI treated with P-PTNS. MATERIAL AND METHODS: We included patients with UUI and FI who were treated with P-PTNS and who completed the bladder/faecal incontinence diary and severity and quality of life questionnaires. We excluded patients with neurogenic UUI and those who abandoned treatment or did not complete the questionnaires. We assessed demographic and clinical variables (micturition/defecation habits pre- and postreatment), severity scales before and after treatment (ICIQ-SF, Sandvick and Wexner), subjective improvement and quality of life (IQOL and FIQL pre- and postreatment). The statistical analysis was conducted using SPSS v19. RESULTS: The sample consisted of 21 patients divided into 2 groups: -UUI group, 9 patients. After P-PTNS, there was a statistically significant improvement in diurnal (p=.018) and nocturnal (p=.016) urinary frequency, urgencies/day (p=.018), urine leakage/day (p=.027), ICIQ-SF and Sandvick (p=.018), and IQOL (p=.012). This improvement was related to exercise (p=.039) and prolapse (p=.05). -Group FI, 12 patients. After P-PTNS, there was a statistically significant improvement in defecation frequency (p=.027), incontinence (p=.012), Wexner scale (p=.007), and FIQL in its 4 dimensions (lifestyle, behaviour, embarrassment p=.005; and depression p=.008). This improvement was related to age (p=.048), time since onset (p=.044) and prolapse (p=.026). CONCLUSIONS: The P-PTNS is effective in UUI and FI refractory to conventional treatment. Treatment response is affected by several factors
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Urinary Incontinence, Urge/therapy , Fecal Incontinence/therapy , Tibial Nerve , Transcutaneous Electric Nerve Stimulation/methods , Quality of Life , Physical Therapy Modalities , Prospective Studies , Patient Health Questionnaire/statistics & numerical data , Reproductive HistoryABSTRACT
OBJECTIVE: The main aim of this study was to assess the efficacy of percutaneous posterior tibial nerve electrostimulation (P-PTNS) in urge urinary incontinence (UUI) and faecal incontinence (FI) refractory to first-line treatment. A secondary aim was to identify predictors of treatment response. To do this, we performed a 2-year analytical, longitudinal and prospective study in patients with UUI and FI treated with P-PTNS. MATERIAL AND METHODS: We included patients with UUI and FI who were treated with P-PTNS and who completed the bladder/faecal incontinence diary and severity and quality of life questionnaires. We excluded patients with neurogenic UUI and those who abandoned treatment or did not complete the questionnaires. We assessed demographic and clinical variables (micturition/defecation habits pre- and postreatment), severity scales before and after treatment (ICIQ-SF, Sandvick and Wexner), subjective improvement and quality of life (IQOL and FIQL pre- and postreatment). The statistical analysis was conducted using SPSS v19. RESULTS: The sample consisted of 21 patients divided into 2 groups: -UUI group, 9 patients. After P-PTNS, there was a statistically significant improvement in diurnal (p=.018) and nocturnal (p=.016) urinary frequency, urgencies/day (p=.018), urine leakage/day (p=.027), ICIQ-SF and Sandvick (p=.018), and IQOL (p=.012). This improvement was related to exercise (p=.039) and prolapse (p=.05). -Group FI, 12 patients. After P-PTNS, there was a statistically significant improvement in defecation frequency (p=.027), incontinence (p=.012), Wexner scale (p=.007), and FIQL in its 4 dimensions (lifestyle, behaviour, embarrassment p=.005; and depression p=.008). This improvement was related to age (p=.048), time since onset (p=.044) and prolapse (p=.026). CONCLUSIONS: The P-PTNS is effective in UUI and FI refractory to conventional treatment. Treatment response is affected by several factors.
