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Previous issue date: 2013-03-27 / Population aging is a reality in all over the world, and aging increases the chance of developing urinary incontinence in women, so it is important to study effective therapeutic strategies and non-invasive for this growing population. The objectives of this study were: review the literature available regarding electrical stimulation and urinary incontinence, and examine the short-and long-term efficacy of transcutaneous tibial nerve electrical stimulation for the treatment of urge urinary incontinence in elderly women. We performed: a systematic review and a randomized clinical trial with 101 older women (> 60 years) with urge incontinence, followed by a cohort study with 50 who had improved after the initial therapy. The systematic review included 30 randomized studies that reported good results for intravaginal electrical stimulation for urge urinary incontinence, tibial nerve electrical stimulation and sacral stimulation in patients refractory; other therapies require further data. The 101 participants were treated with 12 weeks of bladder retraining and pelvic floor muscles training , and 51 were randomly selected to also receive electrical stimulation. The cases were evaluated by 3-day voiding diary, the Kings Health Questionnaire (KHQ) (scale of quality of life related to incontinence), the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and clinical data. The study population had a mean age of 69 years, clinical characteristics, the frequency of urinary incontinence and quality of life before treatment were similar between groups. Both groups showed significant improvement in ICIQ-SF in most KHQ domains, and clinical parameters. However, there was significantly improvement in the group treated with electrostimulation in all domains of the KHQ and ICIQ-SF. Throughout the follow-up, patients who relapsed in the group with electrostimulation, had good results in the repetition of therapy. Electrical stimulation techniques require more randomized trials to establish the benefit of each one for urinary incontinence. Our study showed that the tibial nerve transcutaneous electrical stimulation is safe, effective and durable in elderly patients with urge urinary incontinence. It should be considered the first line therapy to this group of patients. / O envelhecimento populacional ? uma realidade em quase todo o mundo, e, o avan?o da idade aumenta a chance de mulheres desenvolverem incontin?ncia urin?ria, portanto, ? muito importante o estudo de estrat?gias terap?uticas efetivas e n?o-invasivas para esta popula??o cada vez maior. Os objetivos deste estudo foram: revisar a literatura dispon?vel em rela??o a eletroestimula??o e incontin?ncia urin?ria, e; examinar a efic?cia a curto e longo prazo da eletroestimula??o transcut?nea do nervo tibial, para o tratamento de incontin?ncia urin?ria de urg?ncia em idosas. Foram realizadas: uma revis?o sistem?tica, e, um ensaio cl?nico randomizado, com 101 mulheres idosas (> 60 anos) com incontin?ncia urin?ria por urg?ncia, seguido de um estudo de coorte com as 50, que melhoraram com a terapia proposta. A revis?o sistem?tica incluiu 30 estudos randomizados, que relataram bons resultados da eletroestimula??o intravaginal para incontin?ncia urin?ria de urg?ncia, para eletroestimula??o do nervo tibial e, para estimula??o sacral em pacientes refrat?rias, as demais terapias carecem de mais informa??es. As 101 idosas foram tratadas com 12 semanas de retreinamento vesical e exerc?cios de refor?o da musculatura do assoalho p?lvico, sendo que 51 foram selecionadas aleatoriamente para receber tamb?m a estimula??o el?trica. Os casos foram avaliados por: di?rio miccional de 3 dias, Kings Health Questionnaire (KHQ) (escala de qualidade de vida relacionada a incontin?ncia), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) e dados cl?nicos. A popula??o em estudo tinha uma idade m?dia de 69 anos, as caracter?sticas cl?nicas, o n?mero de perdas urin?rias e a qualidade de vida antes do tratamento foram semelhantes entre os grupos. Ambos os grupos apresentaram melhora significativa no ICIQ-SF, na maioria dos dom?nios do KHQ, e nos par?metros cl?nicos. No entanto, houve melhora significativamente superior no grupo tratado com eletroestimula??o em todos os dom?nios do KHQ e no ICIQ-SF. Ao longo do seguimento, as pacientes que recidivaram no grupo com eletroestimula??o, tiveram bom resultado na repeti??o da terapia. As t?cnicas de eletroestimula??o necessitam de mais estudos randomizados para estabelecer o benef?cio de cada uma delas frente a incontin?ncia urin?ria. Nosso estudo mostrou que, a eletroestimula??o transcut?nea do nervo tibial ? segura, efetiva e duradoura, em pacientes idosas com incontin?ncia urin?ria de urg?ncia, podendo ser usada como primeira linha terap?utica neste grupo de pacientes.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2697 |
| Date | 27 March 2013 |
| Creators | Schreiner, Lucas |
| Contributors | Silva Filho, Irenio Gomes da |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
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